Premium
Case of the month. Disseminated histoplasmosis presenting as myositis and fasciitis in a patient with dermatomyositis
Author(s) -
Voloshin Denise K.,
Lacomis David,
McMahon Deborah
Publication year - 1995
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.880180509
Subject(s) - dermatomyositis , myositis , fasciitis , medicine , connective tissue disease , histoplasmosis , dermatology , eosinophilic fasciitis , muscle biopsy , histoplasma , pathology , biopsy , histoplasma capsulatum , surgery , autoimmune disease , disease
A 54‐year‐old man with dermatomyositis initially responsive to corticosteroids and methotrexate developed severe myalgias, increasing weakness, and fevers. Laboratory studies were suggestive of disseminated histoplasmosis, and muscle biopsy revealed myositis, fasciitis, and yeast in the perimysial connective tissue. Histoplasma capsulatum was cultured from skeletal muscle. Despite antifungal therapy, necrotizing fasciitis progressed to gluteal abscess formation. Disseminated histoplasmosis may present atypically in immunocompromised hosts as fasciitis and myositis. Patients with dermatomyositis could be particularly vulnerable to soft tissue invasion by fungi due to their underlying microangiopathy. © 1995 John Wiley & Sons, Inc.