Annals of Tropical Medicine and Public Health
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CASE REPORT
Year : 2016  |  Volume : 9  |  Issue : 4  |  Page : 279-282

An uncommon presentation of progressive disseminated histoplasmosis


Departments of General Medicine, FCCM (NIMS), Consultant Intensivisit, Coordinator Medical Publications, Yashoda Hospital, Hyderabad, Telangana, India

Correspondence Address:
Karishma Rosann Pereira
Yashoda Hospital, Malakpet, Hyderabad, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.184798

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Progressive disseminated histoplasmosis (PDH) caused by Histoplasma capsulatum generally develops in immunocompromised patients or those on long-term systemic corticosteroid therapy. Here, we report a case of PDH in an immunocompetent patient, which is a rare occurrence. A 56- year-old male patient, whose work often led him to caves, now reported with a low-grade fever and altered sensorium. Investigations revealed hyponatremia, bilateral adrenal enlargement, and mediastinal lymphadenopathy. A rare complication of the manifestations of histoplasmosis in an immunocompetent patient, in the form of ring lesions in the brain, came to light during the clinical investigations. The patient developed generalized tonic–clonic convulsions and needed care for the critical condition 2 weeks into treatment. This case report traces the clinical course, histological and serological findings, and response to amphotericin B therapy in the patient.


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