Disseminated Histoplasmosis in a Retropositive Young Male: A Case Report

  • Aniya Antony Department of Pathology, Amala Institute of Medical Sciences
  • Sreeja Raju Department of Pathology, Amala Institute of Medical Sciences http://orcid.org/0000-0003-1220-9226
  • Vanessa John T Department of Pathology, Amala Institute of Medical Sciences
  • Edwin George Department of Pathology, Amala Institute of Medical Sciences
  • Joy Augustine Department of Pathology, Amala Institute of Medical Sciences
Keywords: Disseminated histoplasmosis, retropositive, FNAC, peripheral smear

Abstract

Disseminated histoplasmosis is caused by the dimorphic fungus Histoplasma capsulatum. This fungal infection is commonly seen in immunocompromised patients, especially in AIDS patients, children and elderly population. Here we present a case report of a 24-year-old male who was admitted with generalised fatigue and generalised lymphadenopathy. He was found to be retropositive on evaluation and FNAC of the node surprisingly revealed Histoplasmosis. Presence of these organisms were also seen on the peripheral smear which could be picked up only on reviewing the smear again. With this case report we wish to emphasize the need for careful and diligent search of these organisms in the peripheral smear.

References

Randhawa, H.S., & Gugnani, H. Occurrence of Histoplasmosis in the Indian Sub-Continent: An Overview and Update.Journal of medical research and Practice.2018;3,71-83

Adenis AA, Aznar C, Couppié P. Histoplasmosis in HIV-Infected Patients: A Review of New Developments and Remaining Gaps. Current tropical medicine reports. 2014 Mar 28;1(2):119-128.

Myint T, Leedy N, Villacorta Cari E, Wheat LJ. HIV-Associated Histoplasmosis: Current Perspectives. HIV AIDS (Auckl). 2020 Mar 19; 12:113-125.

Jeong HW, Sohn JW, Kim MJ, et al. Disseminated histoplasmosis and tuberculosis in a patient with HIV infection. Yonsei Med J. 2007;48(3):531-534.

Prasad BSV, Kumar N, Allibhoy FAS, Rao RP, Sayed S, Revathi G. Fine needle aspiration diagnosis of histoplasma lymphadenitis using multidisciplinary expert opinion through telepathology. Recent advances in pathology and lab medicine. 2015;1(1):16-20.

Ebenye CM. A case of disseminated histoplasmosis detected in peripheral blood smear staining revealing AIDS at terminal phase in a female patient from cameroon. Case Rep Med. 2012; 2012:215207.

Qureshi A. A case of Histoplasmosis mimicking Tuberculosis.Journal of the Pakistan medical association. 2008; 58(8): 457-458.

Gupta P and Bhardwaj M. Cytodiagnosis of disseminated histoplasmosis in an immunocompetent individual with molluscum contagiosum like skin lesions and lymphadenopathy. Journal of cytology. 2016; 33(3):163-165.

Agudelo CA, Restrepo CA, Molina DA, Tobón AM, Kauffman CA, Murillo C, Restrepo A. Tuberculosis and histoplasmosis co-infection in AIDS patients. Am J Trop Med Hyg. 2012 Dec;87(6):1094-8.

Caceres DH, Valdes A. Histoplasmosis and Tuberculosis Co-Occurrence in People with Advanced HIV. J Fungi (Basel). 2019 Aug 9;5(3):73.

Zanotti P, Chirico C, Gulletta M, Ardighieri L, Casari S, Roldan EQ, Izzo I et al. Disseminated Histoplasmosis as AIDS presentation. Case report and Comprehensive Review of Current Literature. Mediterranean Journal of Hematology and Infectious Diseases. 2018; 10(1): 1-11.

Kauffman CA. Histoplasmosis: a clinical and laboratory update. Clinical Microbiology Reviews. 2007; 20(1): 115-132.

Bhar, V., Singh, R. Histoplasma capsulatum in peripheral blood neutrophils. J Hematopathol . 2020 ;13 :125–126.

Agrawal J, Bansal N, Arora A. Disseminated histoplasmosis in India presenting as addisonian crisis with epiglottis involvement. IDCases. 2020 May 28;21: e00844.

Hill EV, Cavuoti D, Luu HS, McElvania Tekippe E. The Brief case: Disseminated Histoplasma capsulatum in a patient with newly diagnosed HIV infection/ AIDS. J Clin Microbiol. 2018; 56(3): 1-5.

Published
2021-09-30
Section
Case Report