Evidence map›Paper›PMID 39747737›Full record

ArticleInfection2025

Pathophysiology and clinical outcomes of pancytopenia in disseminated histoplasmosis: a scoping review.

Bassey E Ekeng, David E Elem, Anthony N Kokelu, Asukwo Onukak, Walter O Egbara, Ofonime O Benjamin, Aje N Ogar, Stella T Chukwuma, Love E Okafor, Kingsley A Essien and 2 more

Abstract readScoping Review
PubMed Publisher
In one paragraph

Article in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Bassey E EkengDepartment of Medical microbiology and parasitology, University of Calabar Teaching Hospital, Calabar, Nigeria. basseyewaeekeng@gmail.com.
David E ElemDepartment of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
Anthony N KokeluDepartment of Haematology and Blood Transfusion, University of Calabar Teaching Hospital, Calabar, Nigeria.
Asukwo OnukakDepartment of Internal Medicine, University of Uyo, Uyo, Nigeria.
Walter O EgbaraDepartment of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
Ofonime O BenjaminDepartment of Haematology and Blood Transfusion, University of Calabar Teaching Hospital, Calabar, Nigeria.
Aje N OgarDepartment of Haematology and Blood Transfusion, University of Calabar Teaching Hospital, Calabar, Nigeria.
Stella T ChukwumaDepartment of Medical Microbiology, College of Medicine, Enugu State University of Science and Technology, Enugu, Nigeria.
Love E OkaforDepartment of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
Kingsley A EssienDepartment of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria.
Deborah U EkpenyongDepartment of Community Medicine, University of Benin Teaching Hospital, Edo State, Nigeria.
Felix BongominDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePancytopenia in the setting of disseminated histoplasmosis is sparsely described in the literature. We investigated the underlying mechanisms of pancytopenia in disseminated histoplasmosis and highlighted clinical outcomes.

methodsWe conducted a scoping review of cases and series on disseminated histoplasmosis presenting with pancytopenia published between 2001 and 2024. PubMed database was used for the search. The search terms were (disseminated histoplasmosis) AND (pancytopenia OR haemophagocytic syndrome OR lymphohistiocytosis).

resultsWe identified 72 cases. Forty-four (61.1%) cases were from the Americas, 18 (25.5%) from Asia, 8 (11.1%) from Europe, and 1(1.4%) each from Africa and Australia. Of the 72 cases, five cases (6.9%) were reported in children. The mean age was 41.9 ± 16.7 years with a range of 3 months to 78 years. Seven cases (9.7%) were immunocompetent, 27 (37.5%) had an underlying HIV infection and 45 (62.5%) were complicated with haemophagocytic lymphohistiocytosis syndrome. Histoplasma antigen assay (n = 29, 40.2%) was the major diagnostic method followed by bone marrow biopsy (n = 28, 38.9%). Fifty-three cases (73.6%) recovered, 15 (20.8%) died and outcomes were not stated in 4 cases (5.65%). The relationship between haemophagocytic lymphohistiocytosis and fatal outcomes was not statistically significant (P = 0.5). Likewise, HIV infection was not significantly associated with fatal outcomes (P = 0.6). Fatal outcomes were predominantly due to difficulty or delayed diagnosis of disseminated histoplasmosis and/or haemophagocytic lymphohistiocytosis (n = 5, 6.9%), multiple organ failure (n = 4, 5.6%) and late presentation (n = 2, 2.8%).

conclusionPancytopenia in disseminated histoplasmosis is associated with poor outcomes. Such a hematologic finding should arouse the index of suspicion in the attending clinician for an invasive mycosis like disseminated histoplasmosis to avert fatal outcomes. Besides haemophagocytic lymphohistiocytosis, other factors associated with pancytopenia in disseminated histoplasmosis were the cooccurrence of viral and bacterial infections.

Indexed as

HistoplasmosisPancytopeniaAdolescentAdultAgedChildChild, PreschoolFemaleHistoplasmaHumansInfantLymphohistiocytosis, HemophagocyticMaleMiddle AgedTreatment OutcomeYoung AdultDiagnosisDisseminated histoplasmosisHaemophagocytic lymphohistiocytosisHIV/AIDSPancytopenia

Identifiers

PMID39747737

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.