Histoplasmosis mimicking non-Hodgkin lymphoma in a 40-year-old man with AIDS

Abstract

In patients with acquired immunodeficiency syndrome (AIDS), advanced immunosuppression is associated with atypical presentation of dermatological conditions. Our patient presented with a single crusted plaque over the lower lip and large tender cervical lymphadenopathy. The enzyme-linked immunosorbent assay for human immunodeficiency virus was found to be positive, and his CD4+ lymphocyte cell count was 4 cells/mm. The presence of multiple histoplasma spores in the biopsies from the crusted plaque over lip and cervical lymph node helped in the confirmation of the diagnosis of histoplasmosis, and the patient showed significant improvement within two months of treatment with conventional injection amphotericin B initially followed by oral itraconazole.

Histoplasmosis of Adrenal Gland: A 5 Years' Review from a Multispecialty Diagnostic Centre

“…3,4,6 Asymptomatic adrenal involvement has been described in 30 to 50% of patients with disseminated histoplasmosis and henceforth a meticulous work-up with close follow-up is necessary as there is no clinical diagnostic hallmark of the disease; often, they mimic visceral leishmaniasis, which is prevalent in this part of India, and the diagnosis is often missed. [17][18][19] Increased steroid concentration within the adrenal glands may promote the growth of H. capsulatum, as suggested by some researchers. 20 The histoplasmosis cases from India are based on the study by Randhawa and Gugnani who found a total of 426 cases (1954-2018) and 207 cases from the literature search (2018-2020; excluding studies cited in Randhawa and Gugnani).…”