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Disseminated Histoplasmosis Presenting as Pyrexia of Unknown Origin in a Rheumatoid Arthritis Patient
Hamsa C Maheshwarappa1, Abhishek Singhai2, Vishnu Narayan Mishra3
1Junior Resident, Department of General Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India, Corresponding Author.
Abstract:
We present a case of a 56-year-old female with rheumatoid arthritis (RA) who has been on methotrexate for 9 years and has been complaining of high-grade fever for the past 1 month with no localizing signs and symptoms. She was thoroughly evaluated before being labeled as pyrexia of unknown origin. Histoplasmosis was suspected after bone marrow aspiration smear examination. The presence of histoplasma antigen in the urine confirmed our diagnosis. Fever responded after 2 weeks of liposomal amphotericin B and patient discharged in stable condition on tablet itraconazole.
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