Background: Histoplasmosis is an infection caused by inhalation of spores of the fungus Histoplasma capsulatum. H. capsulatum is not present in the Netherlands but can cause severe disseminated disease in the immunocompromised traveller, with high mortality rate, especially when diagnosis is delayed. Therefore, early recognition is crucial. However, similarities with other infectious diseases, haematological malignancies and auto-immune diseases make timely diagnosis difficult.
Case description: We present a case of a 39-year-old immunocompromised male traveller who presented with disseminated histoplasmosis after a trip to Central America. The diagnosis was made a few months after the first symptoms occurred. He died despite adequate treatment with liposomal amphotericin B.
Conclusion: Disseminated histoplasmosis should be considered as a cause of unexplained fever in immunocompromised patients who travelled to endemic regions. Mortality is high, even when properly treated. Early recognition and treatment improve outcome.