Chronic Disseminated Histoplasmosis Bone Marrow Involvement in an Immunocompetent Patient

Abstract

Histoplasmosis normally do not affect immunocompetent individuals. Prolonged exposure may cause chronic disseminated histoplasmosis. Elderly male patient presented with fever, hematuria and pain in right hypochondrium. He had pallor, fever and mild hepatosplenomegaly. Investigations revealed anemia and thrombocytopenia. Giemsa stained bone marrow aspirate showed yeast-like cells, suggestive of Histoplasma capsulatum. PAS stained bone marrow aspirate and biopsy confirmed the diagnosis.

Coccidioidomycosis and Histoplasmosis in Equines: An Overview to Support the Accurate Diagnosis

“…Chronic pulmonary histoplasmosis, in turn, affects people >50 years, smokers and patients with chronic obstructive pulmonary disease. The clinical signs are quite similar to those observed in chronic pulmonary tuberculosis, though, less severe [78]. Disseminated histoplasmosis is the most serious form of the disease, occurring extrapulmonary and extramediastinal foci of the infection, with a progressive course.…”

“…In both cases, patients with localized pulmonary infections and no risk factors for complications often require only periodic reevaluation to demonstrate spontaneous resolution of their infection, with rest and clinical observation as the most effective measures. On the other hand, patients with extensive spread of infection or who are at high risk of complications due to immunosuppression or other preexisting factors require appropriate treatment strategies [69,78]. In this context, the existing treatments for acute, chronic, or disseminated forms of coccidioidomycosis and histoplasmosis can be prolonged and difficult to tolerate, because the therapy takes months to years.…”

“…In this context, the existing treatments for acute, chronic, or disseminated forms of coccidioidomycosis and histoplasmosis can be prolonged and difficult to tolerate, because the therapy takes months to years. In some patients, suppressive antifungal therapy is needed throughout life to prevent relapse [69,78]. Among the therapeutic options currently available, azoles such as itraconazole, fluconazole, and more recently voriconazole have replaced amphotericin B in the treatment of most infections.…”

A rare case of progressive disseminated histoplasmosis with bone marrow involvement in an immunocompetent patient

“…The common presentation of this disease is fever with abdominal pain, weight loss, hepatosplenomegaly, lymphadenopathy; oral ulcerations, anaemia and thrombocytopenia. 7 Fungal culture remains the gold standard for diagnosis although they can often be negative, the reason for which has been stated before. 1 In progressive disseminated histoplasmosis, thrombocytopenia and other cytopenia are hallmark of bone marrow involvement but rarely reports of patients presenting with isolated thrombocytopenia the present case has been reported.…”

Cutaneous Manifestation of Underlying Disseminated Histoplasmosis in an Immunocompetent Host of Nonendemic Area with Reversible CD4 Cell Depletion and its Recovery on Antifungal Therapy

“…Very few articles have been published on disseminated histoplasmosis in immunocompetent from nonendemic regions of India such as Delhi [15,16], Haryana [17,18], Chandigarh [19], Uttarpradesh [20]. Twelve cases of disseminated histoplasmosis from north-western India had been diagnosed, and their antifungal susceptibilities were performed [21].…”