Histoplasmosis historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Serge Korjian M.D.; Vidit Bhargava, M.B.B.S [2]

Overview

Histoplasma capsulatum was first described by Samuel Taylor Darling in 1906, who coined the term to describe the "plasmodium-like" organisms in the histocytes. In 1912, Henrique da Rocha-Lima, a Brazilian tropical disease specialist, reported findings from a comparison between Leishmania and Histoplasma and concluded that Histoplasma more closely resembled a yeast than a protozoan. In the late 1940s, William A. DeMonbreun, the first person to culture the organism, suggested that the disease may be prevalent in the United States, not only the tropics, due to mild and carrier forms.[1]

Historical Perspective

Initial Discovery

  • Histoplasma capsulatum was first described by Samuel Taylor Darling, an American pathologist, during his work in the Panama Canal Zone.[2]
  • Before Darling's discovery, the disease was unknown.
  • He observed an organism in a in patient's autopsy material that resembled Leishmania that he, at the time, falsely identified as a protozoan.
  • The patient died of a generalized disease associated with hepatosplenomegaly and anemia, a syndrome similar to the findings of Leishman and Donovan.
  • Despite his very crude equipment by modern standards, Darling was able to identify these "plasmodium-like" organisms in histiocytes, hence coining the name Histoplasma.
  • The term "capsulatum" stemmed from Darling's false assumption that the organism has a capsule.[1]

Reclassification

  • In 1912, Henrique da Rocha-Lima, a Brazilian tropical disease specialist, reported findings from a comparison between Leishmania and Histoplasma and concluded that Histoplasma more closely resembled a yeast than a protozoan.
  • Up until the early 1940s, histoplasmosis was considered a fatal tropical disease not prevalent in the United States.
  • Dr. Charles E. Smith was the first person to suggest that the rise in pulmonary calcifications in patients with a negative tuberculin test could be due to Histoplama.[1]

Isolation and Culture

  • In 1928, Dr. Edna H. Tompkins identified the first case of histoplasmosis in a living patient's blood smear.
  • In 1933, Dr. William A. DeMonbreun of Vanderbilt University became the first person to successfully culture H. capsulatum species from the same patient identified by Dr. Tompkins.
  • Dr. DeMonbreun also fulfilled Koch's postulates after he injected the culture material into animals.
  • He also suggested that the disease may not be as low in prevalence as initially hypothesized due to mild and carrier forms.
  • In 1948, Dr. Chester W. Emmons isolated and cultured H.capsulatum from a soil sample for the first time.[1]

Histoplasmosis in Popular Culture

  • Johnny Cash included a reference to the disease, even correctly noting its source in bird droppings, in the song "Beans for Breakfast".
  • Bob Dylan was hospitalized due to histoplasmosis in 1997, causing the cancellation of concerts in the United Kingdom and Switzerland.
  • In the episode Family, episode 21 of season 3 of the television show 'House, M.D.' a patient was diagnosed with histoplasmosis.

References

  1. 1.0 1.1 1.2 1.3 BAUM GL, SCHWARZ J (1957). "The history of histoplasmosis, 1906 to 1956". N Engl J Med. 256 (6): 253–8. doi:10.1056/NEJM195702072560605. PMID 13400245.
  2. Hegner RW (1925). "SAMUEL TAYLOR DARLING 1872-1925". Science. 62 (1593): 23–4. doi:10.1126/science.62.1593.23. PMID 17738786.