Disseminated histoplasmosis as a presenting manifestation in an HIV patient - A case report from South India

• Published in: Indian journal of sexually transmitted diseases and AIDS Vol. 43; no. 2; pp. 203 - 205
• Main Authors: Kiruba Devi, G, Rajamohanan, Remya, Sakkaravarthi, Vinupriya, Toi, Pampa, Munisamy, Malathi
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-07-2022; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow
• Subjects: Antifungal agents; Case Reports; Fungal infections; HIV; Human immunodeficiency virus; Medical diagnosis; HIV; periodic acid-Schiff; Disseminated histoplasmosis; intracellular yeast; periodic acid–Schiff
• ISSN: 2589-0557; 2589-0565
• DOI: 10.4103/ijstd.ijstd_45_21

Histoplasmosis has heterogenous clinical presentation ranging from mild and self-limiting respiratory disease to disseminated forms with high mortality. In progressive disseminated histoplasmosis (PDH), patient presents with fever, lymphadenopathy, hepatosplenomegaly, adrenal enlargement, hemophagocytic lymphohistiocytosis and non-specific mucocutaneous lesions, usually in late stage of HIV. Cutaneous involvement is upto 25% in PDH which are papules, plaques, nodules and ulcers. Forty-two year old male, recently diagnosed as HIV positive presented with complaints of multiple painful ulcerated lesions over face, neck, tongue, arms, trunk & genitalia. Skin Biopsy was suggestive of histoplasmosis. Patient showed excellent response with amphotericin B and itraconazole. Since histoplasmosis is relatively uncommon, there should be a high-index of suspicion when an HIV patient presents with disseminated skin lesions.