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CASE REPORT
Disseminated histoplasmosis presenting as diabetic keto-acidosis in an immunocompetent patient
  1. Negin Niknam1,
  2. Prashant Malhotra1,
  3. Angela Kim2,
  4. Seth Koenig3
  1. 1Department of Infectious Diseases, North Shore University Hospital, Manhasset, New York, USA
  2. 2North Shore University Hospital, Manhasset, New York, USA
  3. 3Long Island Jewish Medical Center, New Hyde Park, New York, USA
  1. Correspondence to Dr Prashant Malhotra, PMalhotr{at}NSHS.edu

Summary

Histoplasma capsulatum causes a spectrum of manifestations from asymptomatic to fatal disseminated disease. Disseminated histoplasmosis is mostly seen in endemic areas among immunocompromised patients such as those with AIDS. Here, we present a patient living in a non-endemic area with previously undiagnosed diabetes mellitus, who presented with septic shock and diabetic ketoacidosis (DKA), and was ultimately diagnosed with disseminated histoplasmosis. The patient rapidly recovered on administration of intravenous liposomal amphotericin followed by oral itraconazole. Uncontrolled diabetes may be a risk factor for disseminated or severe histoplasmosis in otherwise immunocompetent patients.

https://doi.org/10.1136/bcr-2016-217915

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    Footnotes

    • Contributors PM involved in infectious diseases attending following up on the patient as outpatient and literature review. NN wrote the case report. AK involved in initial infectious attending on the case and editing of the case report. SK contributed to critical care attending on the case, editing and literature review.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.