Disseminated Histoplasmosis in a 13-year-old girl: A case report

Abstract

Background: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immunecompromised individuals such as those with acquired immuno-deficiency syndrome. Objective: To describe a case of disseminated histoplasmosis in an adolescent girl. Method: We report a case of disseminated histoplasmosis in a 13-year-old adolescent girl. She was admitted for 16 days because of neck masses of 3 years duration, generalized body swelling of 3 months and reduction in urinary output of 2 months. She tested negative for human immunodeficiency virus antibodies. Result: An autopsy was performed because a definitive diagnosis could not be made while the patient was still alive. The autopsy revealed central caseating areas in the lymph nodes and membranoproliferative glomerulonephritis. The periodic acid-Schiff staining technique for tissues showed viable yeast cells suggestive of histoplasmosis. Zeihl-Neelsen's staining for mycobacteria tuberculosis was negative. Conclusion: Undiagnosed case of disseminated histoplasmosis while the patient was alive is being reported in a 13-yearold girl. Disseminated histoplasmosis should be considered as a differential diagnosis of childhood chronic infections and malignancies as in Nigeria.

A rare case of juvenile systemic lupus erythematosus with disseminated histoplasmosis

“…[1] The disease can be broadly classified into three subtypes: Acute pulmonary form (found in immunocompetent host), chronic pulmonary form (associated with anatomical defect), and disseminated histoplasmosis (seen in immunocompromised individuals). [8]…”

Disseminated histoplamosis in adolescent mimicking granulomatosis with polyangiitis

“…Generalized lymphadenopathy and renal involvement, mainly glomerulonephritis and chronic recurrent abscess of urogenital tract, were the main clinical manifestations of disseminated histoplasmosis in the two cases reported. 5,11 In addition, association of disseminated histoplasmosis with GPA was diagnosed at necropsy in the other patient. 7 Importantly, the confirmed diagnosis was obtained after fungus isolation in renal tissue, fulfilling "proven invasive fungal disease" for disseminated histoplasmosis according to National Institute of Allergy and Infectious Diseases Mycoses Study Group.…”

“…10 The disease can be classified in three subtypes: disseminated histoplasmosis (generally in immunosuppressed patients), acute pulmonary histoplasmosis (mainly in immunocompetent host) and chronic pulmonary histoplasmosis (associated with anatomic defect). 11 This fungal infection is mostly asymptomatic and selfrestrictive in normal children. However it can cause disseminated and acute form in immunocompromised hosts, such as those who receive corticosteroids and immunosuppressive agents, after transplantation and in acquired immune-deficiency syndrome (AIDS) patients.…”

Editorial: Nodding syndrome, infections and sexuality

“…41 Papers on substance abuse among brothel-based female sex workers 42 ; and risky sexual behavior among preparatory school students living with their parents 43 completes this sexuality section. Several papers on hygiene, 44,45 histoplasmosis 46 , tuberculosis diagnosis using GeneXpert® complete the series. 47 Unique in this issue are letters to the editor that touch on death and cadavers, 48,49 , organophosphate poisoning 50…”