A case of haemophagocytic syndrome in HIV-associated disseminated histoplasmosis

Abstract

Disseminated histoplasmosis is an opportunistic infection which is commonly associated with HIV. Haemophagocytic lymphohistiocytosis (HLH) has been described as a secondary phenomenon to infection, collagen – vascular disorders and malignancies. In patients with HIV, cases of reactive haemophagocytic syndrome associated with disseminated histoplasmosis have been reported with CD4 counts of less than 50 cells/μl (450-1660 cells/μl). We report a case of a 25 year old man with HIV who presented with a CD4 count of 153 cells/μl and would suggest that this diagnosis should be considered at higher CD4 counts than previously reported.

Histoplasmosis in patients living with HIV in Europe: review of literature

“…After deduplication, 1,215 articles were included; 1,106 articles were excluded by reading the title and the abstract only, not meeting the pre-defined inclusion criteria. At the end of the review process, 65 articles were included (52 case reports and 13 case series, with additional 37 cases) ( Dietrich et al, 1987 ; Smith et al, 1989 ; Rockstroh et al, 1991 ; Boulard et al, 1994 ; Manfredi et al, 1994 ; Wockel et al, 1994 ; Hofman et al, 1995 ; Trylesinski et al, 1995 ; Eichmann and Schär, 1996 ; Grosse et al, 1997 ; Angius et al, 1998 ; Schöfer and Baur, 1998 ; Guex, 1999 ; Knapp et al, 1999 ; Rieg et al, 1999 ; Antinori et al, 2000 , 2006 ; Farina et al, 2000 , 2005 ; Bilkenroth and Holzhausen, 2001 ; Rivasi et al, 2001 ; Carey et al, 2002 ; Molina et al, 2002 ; Rickerts et al, 2002 ; Calza et al, 2003 ; Lo Cascio et al, 2003 ; Crommentuyn et al, 2004 ; Faggian et al, 2004 ; Terrancle de Juan et al, 2004 ; Ferry et al, 2005 ; Matulionyte et al, 2005 ; Buhk et al, 2006 ; Gil-Brusola et al, 2007 ; Loulergue et al, 2007 ; Albrecht et al, 2008 ; Débat Zoguéreh et al, 2008 ; Peppa et al, 2008 ; De Lavaissière et al, 2009 ; Norman et al, 2009 ; Pellaton et al, 2009 ; Ala-Kauhaluoma et al, 2010 ; Pineau et al, 2010 ; Borges-Costa et al, 2011 ; Bourgeois et al, 2011 ; Inojosa et al, 2011 ; Navascués et al, 2011 ; Vaid and Patel, 2011 ; Carena Smuckler et al, 2012 ; Escher et al, 2012 ; Scarlata et al, 2012 ; Sharma et al, 2012 ; Navarro et al, 2013 ; …”

Hemophagocytic lymphohistiocytosis secondary to histoplasmosis: A case report in a patient with AIDS and recent SARS-CoV-2 infection and minireview

“…A literature search for histoplasmosis associated with HLH in HIV-positive patients yielded 33 papers describing 65 AIDS patients with histoplasmosis and reactive hemophagocytosis. The results are shown in Table 1 [ 10 , 11 , 18 , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] ]. Sex was reported in 60 patients, of whom 45 were male.…”