Histoplasmosis, heart failure, hemolysis and haemophagocytic lymphohistiocytosis

  • Nitin Gupta Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  • Kutty Sharada Vinod Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  • Ankit Mittal Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  • Aswin Pius Ajay Kumar Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  • Arvind Kumar Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  • Naveet Wig Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
Keywords: Pulmonary arterial hypertension; immunocompetent; pancytopenia

Abstract

Histoplasmosis is an endemic mycosis with global distribution, primarily reported in immunocompromised individuals. A 29-year old immunocompetent male presented with fever, hepatosplenomegaly and pancytopenia. His peripheral blood showed features suggestive of intravascular hemolysis and echocardiography showed features suggestive of pulmonary arterial hypertension. Bone marrow showed yeast with morphology suggestive of Histoplasma capsulatum. Further investigations revealed hyperferritinemia, hypofibrinogenemia and increased triglycerides. With a diagnosis of progressive disseminated histoplasmosis with secondary Haemophagocytic lymphohistiocytosis, he was successfully treated with amphotericin B followed by itraconazole. We report this case to highlight the atypical and rare manifestations of histoplasmosis.

Published
2019-01-23
Section
Articles

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eISSN: 1937-8688