Histoplasmosis in Pleural Effusion in a 23-Year-Old Man With Mixed-Phenotype Acute Leukemia

Histoplasmosis has been observed in patients with immunosuppression in the form of isolated pulmonary involvement and disseminated disease. However, very few cases of this type that involved pleural effusion have been reported, and none have been reported in a case individual with mixed-phenotype acute leukemia (MPAL). Herein, we report a case involving a 23 year old Punjabi man having fever and breathlessness in the postinduction therapy period for mixed-phenotype acute leukemia (MPAL) with diagnosis of histoplasmosis based on the results of pleural fluid cytologic testing. The diagnosis of histoplasmosis may be missed in routine pleural fluid cytology testing; however, a high degree of suspicion for opportunistic infections in patients with immunocompromised state can aid diagnosis.