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Disseminated histoplasmosis in an immunocompetent patient with COVID-19 pneumonia
  1. Genesis Perez Del Nogal1,
  2. Andres Mata2,
  3. Prince Ernest1 and
  4. Ivania Salinas1
  1. 1Internal Medicine, TTUHSC SOM Permian Basin, Odessa, Texas, USA
  2. 2School of Medicine, University of Carabobo, Valencia, Carabobo, Venezuela, Bolivarian Republic of
  1. Correspondence to Dr Genesis Perez Del Nogal; genesisdelnogal{at}


Disseminated histoplasmosis is usually associated with immunosuppressive conditions like AIDS. People with respiratory distress syndrome secondary to SARS-CoV-2 pneumonia are vulnerable to bacterial infections. Additionally, coinfection with fungal pathogens should be considered as a differential diagnosis even in immunocompetent patients who remain on mechanical ventilation secondary to COVID-19. The case presents a 61-year-old immunocompetent man, admitted to the medical ward due to COVID-19 pneumonia. Despite appropriate therapy, the patient required transfer to the intensive care unit for invasive mechanical ventilation. He remained critically ill with worsening respiratory failure. Two weeks later, coinfection by disseminated histoplasmosis was detected. After immediate treatment with amphotericin B and itraconazole, the patient tolerated weaning from mechanical ventilation until extubation. Awareness of this possible fungal coinfection in immunocompetent patients is essential to reduce delays in diagnosis and treatment, and prevent severe illness and death.

  • COVID-19
  • infectious diseases
  • pneumonia (infectious disease)
  • adult intensive care
  • TB and other respiratory infections

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  • Contributors GPDN and AM wrote the manuscript with support from PE and IS. All authors discussed the results and contributed to the final manuscript.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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