Disseminated histoplasmosis in a 17-year-old Nigerian male patient: A case report

ABSTRACT

Rationale Disseminated histoplasmosis is the most severe form of histoplasmosis and often associated with fatal outcomes. Both pulmonary and disseminated forms mimics tuberculosis (TB) and may be misdiagnosed. Patient concerns A 17-year-old male patient compliant with antituberculosis therapy with complaints of fever, cough productive of thick yellowish sputum, fast breathing, abdominal pain, swelling and jaundice. HIV status was negative. Diagnosis Disseminated histoplasmosis. Interventions: Antimicrobials including anti-TB therapy, ceftriaxone, gentamicin, azithromycin and ciprofloxacin. Outcomes: He was responding to anti-TB drugs until about 4 and a half months on treatment when he fell ill. Peripheral blood film done 2 days prior to his demise revealed florid yeast like organisms in monocytes with eccentric chromatin suggestive of Histoplasma capsulatum. Lessons Histoplasmosis can both mimic and coexist with TB and so a high index of suspicion is needed for its diagnosis.