Fungal Infection Causing a Diagnostic Dilemma!
Tasneem S. Bohra *
Lilavati Hospital and Research Centre, Bandra Reclamation, Bandra West, India.
Hakim Shaikh
Lilavati Hospital and Research Centre, Bandra Reclamation, Bandra West, India.
Pralhad Prabhudesai
Lilavati Hospital and Research Centre, Bandra Reclamation, Bandra West, India.
*Author to whom correspondence should be addressed.
Abstract
Histoplasmosis is a fungal infection caused by Histoplasma capsulatum, which is distributed worldwide. Disseminated Histoplasmosis (DH) is one of its rare forms. Non-recognition of the true burden of Histoplasmosis in the Indian sub-continent is attributed to its possible misdiagnosis as Tuberculosis, malignancy or other diseases. We report a case of a young immunocompetent male who was diagnosed to have DH, later complicated by HLH. Timely diagnosis and treatment is the linchpin of management of DH, as it can prove fatal if left untreated. We present this case, taking it as our experience, to increase awareness regarding the presence of DH along with HLH, despite the immunocompetent status of our patient. Our case illustrates the challenges we posed during diagnosis; and how in TB endemic areas, pulmonary Histoplasmosis can be misdiagnosed.
Keywords: Histoplasmosis, Hemophagocytic lymphohistiocytosis (HLH), immunocompetent, Tuberculosis, adrenal enlargement, bone marrow biopsy, skin biopsy