Open AccessProgressive disseminated histoplasmosis in idiopathic CD4 lymphocytopenia an underdiagnosed combination - a case report
Author(s) -
Prakrati Yadav,
Dinesh Kumar,
Gopal Krishana Bohra,
Mahendra Kumar Garg,
Juhi Bharti,
Abhishek Purohit,
Durga Shankar Meena
Publication year - 2021
Publication title -
medicine and pharmacy reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.35
H-Index - 16
eISSN - 2668-0572
pISSN - 2602-0807
DOI - 10.15386/mpr-1908
Subject(s) - histoplasmosis , medicine , lymphocytopenia , hepatosplenomegaly , leukopenia , itraconazole , dermatology , rash , amphotericin b , histoplasma , pediatrics , surgery , pathology , chemotherapy , antifungal , histoplasma capsulatum , disease , lymphocyte
Progressive disseminated histoplasmosis (PDH) usually presents as fever, anemia, leukopenia, hepatosplenomegaly, lymphadenopathy and pulmonary symptoms. There are few reports showed the association of Idiopathic CD4 lymphocytopenia (ICL) with histoplasmosis. We describe a 65-year-old female presented with history of fever, papulo-nodular rash and significant weight loss and diagnosed as progressive disseminated histoplasmosis. All immunocompromised conditions were ruled out. In addition, her 2 consecutive CD4 counts were below 300. The patient was diagnosed with PDH associated with ICL. Patient showed significant improvement with liposomal amphotericin B and itraconazole. Absolute CD4 counts should be done in all cases of progressive disseminated histoplasmosis even in HIV negative individuals to rule out associated ICL.