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Case report
Disseminated histoplasmosis and tuberculosis: dual infection in a non-endemic region
  1. Karuna Anot,
  2. Sanjana Sharma,
  3. Monica Gupta and
  4. Daljinderjit Kaur
  1. Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
  1. Correspondence to Professor Monica Gupta; monicamanish2001{at}gmail.com

Abstract

Histoplasmosis is a systemic fungal infection caused by Histoplasma capsulatum, a dimorphic fungus that spreads commonly by contamination of soil with bird and bat droppings. The infection remains latent in most patients until manifested by reduced immune status, for example, HIV/AIDS, corticosteroid/immunosuppressive therapy or in solid organ transplant recipients. Tuberculosis and histoplasmosis may cooccur rarely in HIV and the clinical resemblance of both diseases may hinder identification of patients’ harbouring dual infection, especially in regions non-endemic for histoplasmosis. We report a case of disseminated histoplasmosis with disseminated tuberculosis in an incidentally detected patient with HIV-positive who presented with reports of fever and skin rash for 10 days. The Mantoux positivity and CT of chest and abdomen revealing multiple necrotic lymph nodes coupled with bone marrow and skin biopsy divulging histoplasmosis and tuberculosis helped us clinch the concurrent infection.

  • TB and other respiratory infections
  • HIV / AIDS
  • tropical medicine (infectious disease)

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Footnotes

  • Contributors All the authors have provided substantial contributions in the clinical management of the case and literature review on the topic in question. KA and SS have drafted the manuscript and MG and DK have revised it critically for important intellectual content. All the authors have read the final version and approved it. All the authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

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

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