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Ovarian histoplasmosis in systemic lupus erythematosus

P A Isotalo1, A E McCarthy, L Eidus

  • 1Department of Pathology, University of Ottawa, Ontario, Canada.

Pathology
|June 7, 2000
PubMed

Insights

Disseminated histoplasmosis, a fungal infection, rarely affects patients with Systemic Lupus Erythematosus (SLE). This case highlights ovarian histoplasmosis causing anovulation in an SLE patient, suggesting potential reactivation of latent disease.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Immunology

Background:

  • Histoplasma capsulatum causes histoplasmosis, typically a pulmonary infection acquired via inhalation.
  • Disseminated histoplasmosis can occur in immunocompromised individuals, including those with autoimmune disorders like Systemic Lupus Erythematosus (SLE).
  • SLE is associated with immune defects, increasing susceptibility to infections, though disseminated histoplasmosis is an uncommon complication.

Observation:

  • A 32-year-old woman with SLE presented with a 2-year history of irregular menses and an anovulatory state.
  • Ovarian histoplasmosis was incidentally discovered during surgery for a persistent colo-cecal fistula.
  • The patient had no signs of active pulmonary histoplasmosis.

Findings:

  • The anovulatory state in the SLE patient was attributed to ovarian histoplasmosis.
  • Disseminated histoplasmosis in this case likely resulted from the reactivation of a previously latent infection.
  • This represents the first reported instance of disseminated histoplasmosis manifesting as ovarian dysfunction in a patient with SLE.

Implications:

  • This case expands the known clinical presentations of disseminated histoplasmosis.
  • It underscores the importance of considering opportunistic infections, including fungal infections, in SLE patients with atypical symptoms.
  • Reactivation of latent histoplasmosis should be considered in immunocompromised patients presenting with unusual organ involvement.

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