Disseminated histoplasmosis in immunocompetent patients
Abstract
Histoplasmosis is a fungal infection that is acquired by inhalation causing lung disease in its primary form. It can spread to other organs, especially in immunosuppressed patients in whom it reaches high mortality. It is endemic in certain areas, especially temperate and tropical ones. The clinical manifestations vary according to the person's spread and immune status. The diagnosis is made by histopathological identification, culture and serology.
African-American young adult female patient with no clinical history presenting a one-year history characterized by involuntary weight loss, alopecia, hyperpigmented skin lesions, diarrhea and cervical lymphadenopathies whose histopathological study was compatible with histoplasmosis. Extension studies suggested, but did not confirm, an associated autoimmune pathology.
In Ecuador there is no record of cases of histoplasmosis despite being considered an endemic mycosis in the area. The immunocompetence study in the present case was suggestive of systemic lupus erythematosus with overlapping manifestations. Systemic lupus erythematosus patients are susceptible to opportunistic fungal infections due to intrinsic immune defects with impaired cellular immunity.
Histoplasmosis is an endemic disease in our environment, underdiagnosed by the diversity of the clinical picture and its association with other pathologies.
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