A Rare Case of Juvenile Systemic Lupus Erythematosus with Disseminated Histoplasmosis

Area of Science:

• Medical Mycology
• Immunology
• Pediatric Rheumatology

Background:

• Histoplasmosis is a systemic fungal infection caused by *Histoplasma capsulatum*.
• Immunocompromised individuals are at high risk for disseminated disease.
• Juvenile systemic lupus erythematosus (JSLE) significantly increases susceptibility to opportunistic infections.

Purpose of the Study:

• To report an extremely rare case of progressive disseminated histoplasmosis in a patient with JSLE.
• To highlight the severe consequences of opportunistic fungal infections in pediatric autoimmune diseases.
• To underscore the importance of early diagnosis and aggressive management.

Main Methods:

• Case report of a 13-year-old female diagnosed with JSLE.
• Clinical presentation and diagnostic workup for disseminated fungal infection.
• Treatment course involving antifungal therapy and management of septic shock.

Main Results:

• The patient developed severe opportunistic histoplasmosis despite aggressive antifungal treatment.
• The infection rapidly progressed to septic shock, leading to a fatal outcome.
• This case represents only the second documented instance of this association in medical literature.

Conclusions:

• Progressive disseminated histoplasmosis is a life-threatening complication in pediatric patients with JSLE.
• Aggressive antifungal therapy may not always prevent fatal outcomes in severe opportunistic infections.
• Vigilance for fungal infections is crucial in immunocompromised pediatric patients with autoimmune conditions.