Disseminated Histoplasmosis in an Immunocompetent Host presenting as Pyrexia of unknown origin (PUO)

Sanjay Pandit, Naresh Kumar, Pratap Singh, Shivani Bansal, Rashmi Jain Gupta


Histoplasmosis is a progressive granulomatous disease caused by intracellular dimorphic  fungus Histoplasma capsulatum. The fungus present in the soil infects through inhalational route and can manifest as any of the three main types – Acute primary pulmonary type, chronic cavitatory or progressive  disseminated. In Disseminated histopasmosis (DH) the fungus is detected from more than one location in the body. This is the rarest form of all three types and is usually present in immunocompromised individuals. We report the case of a 27-year-old immunocompetent patient who presented with prolonged fever, weight loss, pain abdomen and skin lesions. She was found to have hepatosplenomegaly and pancytopenia. Biopsy from skin lesions and bone marrow stained positive for Histoplasma capsulatum sp. She was treated with amphotericin B for 28 days, followed by oral itraconazole for 6 months, leading to complete resolution of the disease. This case is interesting due to the presence of disseminated histoplasmosis in an immunocompetent host with prominent skin lesions.


Histoplasmosis, Immunocompetent

Full Text:



George S. Deepe Jr.. Histoplasma capsulatum Mandell, Douglas & Bennett’s Principles & Practice of Infectious disease 7th edition 2010 : 3305-3318

Randhawa H.S. , Khan Z.U. Histoplasma in India : Current status . Indian J Chest Disease Allied Sci 1994 ;36:193-213

S. Subramanian, O.C. Abraham, P.Rupali, A. Zachariah, Mary S. Mathews, D. Mathai . Disseminated Histoplasmosis . JAPI 2005;53:185-189

Gopalakrishnan R, Senthur Nambi P, Ramasubramanian V, Abdul Ghafur K, Parameswaran A. Histoplasmosis in India: truly uncommon or uncommonly recognized? JAPI 2012;60:25-28

Diybendu De & Uttam Kumar Nath . Disseminated Histoplasmosis in immunocompetent individuals - not a so rare entity in India . Meditteranean Journal of Hematology & Infectious Disease 2015 ; 7(1) : e2015028

Bolognia JL, Jorizzo JL, Schaffer JV. Dermatology. 3rd edition. New York: Elsevier: Saunders; 2012

Paul AY, Aldrich S, Scott RS, Ellis MW. Disseminated histoplasmosis in a patient with AIDS: case report and review of literature. Cutis. 2007;80:309–312

Goodwin RA Jr, Shapiro JL , Thurman GH et al Disseminated Histoplasmosis : Clinical and pathological correlations Medicine ( Baltimore ).1980;59:1-31

Blair TP,Waugh RA,Pollack M,et al Histoplasma Capsulatum endocarditis . Am Heart J. 1980;99:783-788

Sturium HS, Kouchoukos NT, Ahluvin RC . Gastrointestinal manifestations of disseminated histoplasmosis . Am J Surg 1965;110:435-440

Wheat LJ, Batteiger BE, Sathapatayavongs B. Histoplasma capsulatum infections of the central nervous system : a clinical review Medicine ( Baltimore) 1990;69:244-260

Wilson DA, Muchmore Hg,Tisdal RG, et al Histoplasmosisof the adrenal glands studiedby CT. Radiology 1984;150:779-783

1. Wheat J, Sarosi G, McKinsey D, Hamill R, Bradsher R, Johnson P, Loyd J, Kauffman C. Practice Guidelines for Management of Patients with Histoplasmosis. Clinical Infectious Diseases 2000; 30-688-695.

Klein NC, Cunha BA. New antifungal drugs for pulmonary mycoses. Chest 1996;110:525-532.

Dismukes WE, Brdsher RWJr, Cloud GC, et al. Itraconazole therapy for blastomycosis and histoplasmosis. NIAID Mycosis study Group. Am J Med 1992; 93: 489-497.


  • There are currently no refbacks.

Copyright (c) 2017 Journal of Advanced Research in Medicine