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Histoplasmosis and subcutaneous nodules in a kidney transplant recipient: erythema nodosum versus fungal panniculitis
Author(s) -
Dufresne S.F.,
LeBlanc R.E.,
Zhang S.X.,
Marr K.A.,
Neofytos D.
Publication year - 2013
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12052
Subject(s) - panniculitis , erythema nodosum , medicine , histoplasmosis , pathology , differential diagnosis , dermatology , transplantation , kidney transplantation , biopsy , skin biopsy , organ transplantation , surgery , disease
Abstract Erythema nodosum ( EN )‐like lesions are a rare occurrence after solid organ transplantation. Differential diagnosis includes infective panniculitis, which can be a feature of progressive disseminated histoplasmosis ( PDH ), an uncommon but severe form affecting primarily immunocompromised hosts. We report on a fatal case of PDH , which presented as fungal panniculitis masquerading as EN in a renal allograft recipient 25 years after transplantation. We discuss the clinical, histopathological, and microbiological characteristics of this rare complication, with focus on its distinction from EN . This case emphasizes the central role of biopsy in transplant recipients presenting with cutaneous lesions, and the importance of clinicopathologic correlation and complementary microbiological investigations.