ABSTRACT
Genital involvement is an unusual manifestation of histoplasmosis. We report a case of histoplasmosis presenting as granulomatous epididymo-orchitis and review 4 cases reported in the literature. Diagnosis of this infection is suggested by a compatible clinical picture and results of specific serology or antigen testing, but confirmation ultimately requires analysis of pathologic specimens. Surgical drainage or resection of involved tissues and systemic antifungals typically result in resolution of infection and improved outcomes.
Subject(s)
Epididymitis/diagnosis , Granulomatous Disease, Chronic/diagnosis , Histoplasmosis/diagnosis , Orchitis/diagnosis , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Epididymitis/drug therapy , Epididymitis/microbiology , Granulomatous Disease, Chronic/drug therapy , Granulomatous Disease, Chronic/microbiology , Histoplasma/isolation & purification , Histoplasmosis/complications , Histoplasmosis/drug therapy , Humans , Male , Middle Aged , Orchitis/drug therapy , Orchitis/microbiologyABSTRACT
We report a case of osteomyelitis due to Mycobacterium avium-intracellulare complex (MAC) in an AIDS patient shortly after the initiation of antiretroviral therapy with subsequent immune reconstitution inflammatory syndrome (IRIS). He improved after surgical debridement and treatment with clarithromycin, ethambutol, rifabutin, and low-dose corticosteroids. Antiretroviral therapy was not interrupted. MAC should be suspected in IRIS-related complications such as osteomyelitis.
