Case Report. Successful therapy of disseminated histoplasmosis in AIDS with liposomal amphotericin B

A 36‐year‐old HIV‐infected male patient presented with relapsing fever episodes to 39 °C, night sweats and weight loss. Computerized tomography of the abdomen showed enlarged multiple lymph nodes. After surgical resection of multiple lymph nodes, disseminated infection with Histoplasma capsulatum was diagnosed. Amphotericin B desoxycholate was initiated for 24 days. Fourteen days after therapy was discontinued, the patient suffered similar symptoms again. Subsequent treatment with liposomal amphotericin B led to rapid improvement within 3 days. Upon discharge, maintenance therapy with 600‐mg itraconazole capsules was initiated and decreased to 400‐mg 14‐days later. Itraconazole therapy was continued until the patient died more than 2 years later because of complications of the underlying disease. At autopsy there were no signs of histoplasmosis.