Disseminated Histoplasmosis without Pulmonary Involvement in an Immunocompetent Host - A Case Report

Abstract

Histoplasmosis is a dimorphic fungal infection caused by histoplasma capsulatum. It is the most prevalent
endemic mycosis in the United States, but now it is a disease of world wide occurrence. Most infections are
asymptomatic or self-limited, some individuals develop acute pulmonary infections or severe and progressive
disseminated infection. Progressive disseminated histoplasmosis occurs in about one in 2000 patients with acute
infection. Besides lung it may affect skin, lymph nodes, GIT, CNS, adrenals, liver and spleen. The patient of
disseminated histoplasmosis usually presents with fever, anorexia, weight loss, myalgia and manifestations
according to organ involved. Here we described a 45 year-male who presented to us with fever, weight loss,
generalized lymphadenopathy, growths in the oral cavity and chylous ascites. The particular interest of this paper
is to present a case of disseminated histoplasmosis in an immunocompetent host without pulmonary involvement,
and to demonstrate the differences between this entity and other similarly presented diseases like disseminated
tuberculosis, lymphoma and metastatic malignancy.

Key words: histoplasmosis; disseminated histoplasmosis; histoplasma capsulatum; immunocompetent host; Bangladesh.

DOI: 10.3329/bsmmuj.v3i1.5515

BSMMU J 2010; 3(1): 44-46