Disseminated Histoplasmosis in Immunocompetent Patients Presented with Fever of Unknown Origin (FUO)

Authors

  • Md Sohidul Islam Medical Officer, Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Md Rehan Habib Assistant Professor, Department of Gastroenterology, Sir Salimullah Medical College Hospital, Dhaka, Bangladesh
  • Elmay Taswafe Asha FCPS Part II Trainee, Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Mahbuba Sharmin Medical Officer, Department of Hematology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Mehnaj Ashraf Resident, Department of Hematology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Abdullah Al Mahmud Resident, Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Amin Lutful Kabir Associate Professor, Department of Hematology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Md Rafiqul Alam Professor, Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • Fazle Rabbi Chowdhury Associate Professor, Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/jom.v24i1.64906

Keywords:

Fever, Disseminated Histoplasmosis

Abstract

Histoplasmosis is underreported although in Southeast Asia including Bangladesh is thought to be endemic considering the favorable geo-climatic conditions for the organism. Non-recognition of histoplasmosis is particularly attributed to possible misdiagnosis as tuberculosis (which is endemic here and common in Bangladesh) because histoplasmosis mimics tuberculosis in clinical presentation, imaging and histopathology. Disseminated histoplasmosis mainly occur in immunocompromised patients and rare in immunocompetent subjects. Here we are reporting two cases of disseminated histoplasmosis where both were immunocompetent and presented with FUO. Both patients visited several health centers before coming to us with no definite diagnosis and we got them in a progressive stage. Both were confirmed through bone marrow study. Unfortunately, one of them died from disease progression, sepsis and other complications and another patient gradually improved with treatment (amphotericin B and itraconazole). We are reporting these cases to highlight the fact that disseminated histoplasmosis does occur in immunocompetent patient and may occur with or without pulmonary symptoms. A high index of suspicion is required for diagnosis and delay can often be fatal.

J MEDICINE 2023; 24: 59-64

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Published

2023-03-22

How to Cite

Islam, M. S. ., Habib, M. R. ., Asha, E. T. ., Sharmin, M. ., Ashraf, M. ., Mahmud, A. A. ., Kabir, A. L. ., Alam, M. R. ., & Chowdhury, F. R. . (2023). Disseminated Histoplasmosis in Immunocompetent Patients Presented with Fever of Unknown Origin (FUO). Journal of Medicine, 24(1), 59–64. https://doi.org/10.3329/jom.v24i1.64906

Issue

Vol. 24 No. 1 (2023)

Section

Case Reports

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