An unusual presentation of disseminated histoplasmosis in a non-HIV patient from Vietnam

Abstract

Background: Histoplasmosis is a systemic infection caused by the dimorphic fungus Histoplasma capsulatum, naturally found in nitrogen-rich soil, whose main transmission route is the inhalation of conidia. Up to 95% of histoplasmosis cases are asymptomatic or transient, and the remaining 5% of cases have pathological manifestations in the lungs, bone marrow, liver, spleen, intestine, mucous membranes, and rarely on the skin. This mycosis has been reported from many endemic areas, mainly in immunosuppressed patients, such as HIV-positive patients, and its disseminated form is rarely reported.

Case report: Histoplama capsulatum was isolated and identified by means of microscopy, culture characteristics and nested PCR from the cutaneous lesions of a non-HIV patient from Vietnam. The patient improved significantly with systemic itraconazole treatment.

Conclusions: Disseminated histoplasmosis with cutaneous involvement in non-HIV patients is an extremely unusual presentation.

Keywords: Cutaneous histoplasmosis; Disseminated histoplasmosis; HIV-patient; Histoplasma capsulatum; Histoplasmosis cutánea; Histoplasmosis diseminada; Paciente VIH; Vietnam.