Disseminated histoplasmosis and tuberculosis: dual infection in a non-endemic region

Histoplasmosis is a systemic fungal infection caused by a dimorphic fungus that spreads commonly by contamination of soil with bird and bat droppings. The infection remains latent in most patients until manifested by reduced immune status, for example, HIV/AIDS, corticosteroid/immunosuppressive ther...

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Bibliographic Details
Published in:BMJ case reports 2020-08, Vol.13 (8), p.e235531
Main Authors: Anot, Karuna, Sharma, Sanjana, Gupta, Monica, Kaur, Daljinderjit
Format: Article
Language:English
Subjects:
Abdomen
Abdomen - diagnostic imaging
Acquired immune deficiency syndrome
AIDS
AIDS-Related Opportunistic Infections
Biopsy
Blood platelets
Bone marrow
Bone Marrow - pathology
Case reports
Coinfection
Fever
Forehead - pathology
Hepatitis
Histoplasmosis
HIV
Human immunodeficiency virus
Humans
Immunocompetence
Infections
Lymph Nodes - pathology
Lymphatic system
Male
Middle Aged
Organisms
Patients
Rare Disease
Skin
Skin - pathology
Tomography, X-Ray Computed
Tropical diseases
Tuberculosis
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Summary:Histoplasmosis is a systemic fungal infection caused by a dimorphic fungus that spreads commonly by contamination of soil with bird and bat droppings. The infection remains latent in most patients until manifested by reduced immune status, for example, HIV/AIDS, corticosteroid/immunosuppressive therapy or in solid organ transplant recipients. Tuberculosis and histoplasmosis may cooccur rarely in HIV and the clinical resemblance of both diseases may hinder identification of patients' harbouring dual infection, especially in regions non-endemic for histoplasmosis. We report a case of disseminated histoplasmosis with disseminated tuberculosis in an incidentally detected patient with HIV-positive who presented with reports of fever and skin rash for 10 days. The Mantoux positivity and CT of chest and abdomen revealing multiple necrotic lymph nodes coupled with bone marrow and skin biopsy divulging histoplasmosis and tuberculosis helped us clinch the concurrent infection.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-235531