Disseminated histoplasmosis as presenting feature of acquired immunodeficiency syndrome: a case report

Histoplasmosis is a mild self-limiting respiratory illness in immune-competent individuals. It disseminates in immune-suppressed states like patients with human immunodeficiency virus (HIV) infection, haematological malignancies, post transplant states and patients receiving immunesuppressive therapy. Here we report a case of disseminated histoplasmosis in a 45 year old diabetic, returning worker who presented with fever, cough, rash, oro-genital ulcer and weight loss. He was anaemic, there was crepitation on lung auscultation and hepatomegaly. Diagnostic workup revealed HIV infection with disseminated histoplasmosis. Intravenous amphotericin B was started along with other supportive therapy and for anti-retroviral therapy he was sent to a referral center. Being an uncommon condition in our perspective, we are reporting the case. DOI: http://dx.doi.org/10.3329/bjmed.v24i2.20221 Bangladesh J Medicine 2013; 24 : 78-81