A Rare Primary Mucocutaneous Presentation of Chronic Disseminated Histoplasmosis in an Immunocompetent Young Female: A Case Report

  • Ankita Shashikant Shende Department of Pathology, Lokmanya Tilak Municipal Medical College, Sion, Mumbai
  • Madhu Ishwarchand Chaturvedi Department of Pathology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai
Keywords: Disseminated, histoplasmosis, immunocompetent, mucocutaneous


Classical Histoplasmosis also known as Darling’s disease is a systemic mycosis caused by dimorphic fungus, Histoplasma capsulatum var capsulatum and Histoplasma capsulatum var duboisii. It is an opportunistic fungal infection that usually affects immunocompromised patients. Though microbiology culture methods are the gold standard, scrape cytology and histopathology give a relatively rapid diagnosis. It may pose a diagnostic dilemma on histopathology and morphology needs to be carefully studied to rule out other differentials. We present a rare case of chronic disseminated histoplasmosis with primary mucocutaneous lesions in an immunocompetent young female patient. This study is ethically approved from the institute and due written consent for publication from the patient has been taken.


Hay RJ, Moore M. Mycology. In: Champion RH, Burton JL, Burns DA, Breathnach SM, editors. Rook/Wilkinson/Ebling Textbook of dermatology. 6th ed. Oxford: Oxford Blackwell Science; 1998. pp. 1363–6.

Radhakrishnan S, Vanchilingam S, Subramaniam S, Venkatraman IT. Acute disseminated histoplasmosis with unusual features. An autopsy report. J Assoc Phys India. 1982;30:45–8.

Rippon JW. The Pathogenic fungi and the pathogenic actinomycetes. 3rd ed. Philadelphia: WB Saunders; 1988. pp. 381–417.

Sanyal M, Thammaya Skin sensitivity to histoplasmin in Calcutta and its neighborhood. Indian J Dermatol VenereolLeprol. 1980;46:94–8.

Mukherjee AM, Khan KP, Sanyal M, Basu N. Histoplasmosis in India with report of two cases. J Ind Med Assoc. 1971;56:121–5.

Gugnani HC. Histoplasmosis in Africa Indian. J Chest Dis Allied Sci. 2000;42:271–7.

De D, Nath UK. Disseminated Histoplasmosis in Immunocompetent Individuals- not a so Rare Entity, in India. Mediterr J Hematol Infect Dis. 2015;7(1):e2015028. Published 2015 Apr 20. doi:10.4084/MJHID.2015.028.

Saoji AM, Grover S, Mene AR, Patoria NK, Sharma KD. Histoplasmosis. J Indian Med Assoc. 1976;66:37–8. [PubMed: 1032503]

Nair SP, Vijayadharan M, Vincent M. Primaty cutaneous histoplasmosis. Indian J Dermatol VenereolLeprol. 2000;66:151–3. [PubMed: 20877062]

Taylor GD, Fanning EA, Ferguson JP. Disseminated histoplasmosis in a Nonendemic area. Can Med Assoc J. 1985;33:763–5. [PMCID: PMC1346464] [PubMed: 4042060]

Chandler FW, Kaplan W, Ajello L. A Colour Atlas And Textbook Of The Histopathology Of Mycotic Diseases.1st Ed, Chapter 14, pg 67 -69.

Hernández SL, López De Blanc SA, Sambuelli RH, Roland H, Cornelli C, Lattanzi V, et al. Oral histoplasmosis associated with HIV infection: A comparative study. J Oral Pathol Med 2004;33:445-50.

Wheat LJ, Connolly-Stringfield PA, Baker RL, Curfman MF, Eads ME, Israel KS, et al. Disseminated histoplasmosis in the acquired immune deficiency syndrome: clinical findings, diagnosis and treatment, and review of literature. Medicine (Baltimore) 1990;69:361–74.

Harnalikar M, Kharkar V, Khopkar U. Disseminated cutaneous histoplasmosis in an immunocompetent adult. Indian J Dermatol. 2012;57:206–9.

Santosh et al. Disseminated histoplasmosis in an immunocompetent patient - utility of skin scrape cytology in diagnosis: a case report. Journal of Medical Case Reports (2018) 12:7.

Wheat LJ, Azar MM, Bahr NC, Spec A, Relich RF, Hage C. Histoplasmosis. Infect Dis Clin North Am. 2016;30(1): 207–227.

Vidyanath S, Shameena P M, Sudha S, Nair RG. Disseminated histoplasmosis with oral and cutaneous manifestations. J Oral MaxillofacPathol2013;17:139-42.

Minamoto GY, Rosenberg AS. Fungal infections in patients with acquired immunodeficiency syndrome. Med Clin North Am. 1997;81:389–409.

Ferreira OG, Cardoso SV, Borges AS, Ferreira MS, Loyola AM. Oral histoplasmosis in Brazil. Oral Surg Oral Med Oral Pathol Oral RadiolEndod2002;93:654-9.

Mignogna MD, Fedele S, Lo Russo L, Ruoppo E, Lo Muzio L. A case of oral localized histoplasmosis in an immunocompetent patient. Eur J Clin Microbiol Infect Dis 2001;20:753-5.

Rocha MM, SeveroLC.Disseminated histoplasmosis in patients with acquired immunodeficiency syndrome (AIDS). Study of 25 cases. Rev Inst Med Trop Sao Paulo 1994;36:167-70.

Souza Filho FJ, Lopen M, Almeida OP, Scully C. Mucocutaneous histoplasmosis in AIDS. Br J Dermatol 1995;33:472-4.

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