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Disseminated histoplasmosis with skin manifestations in advanced HIV: Case report

Francisco Arreola-Banda, Olivia López-Lachica1, Guillermo García-Maldonado1

  • 1Instituto Mexicano del Seguro Social, Hospital General de Zona No. 33, Servicio de Medicina Interna. Monterrey, Nuevo León, México.

Revista Medica Del Instituto Mexicano Del Seguro Social
|November 7, 2024
PubMed
Abstract

Insights

Disseminated histoplasmosis is a fatal opportunistic infection in advanced HIV/AIDS patients, often presenting with nonspecific symptoms and skin lesions. Early diagnosis and treatment adherence are crucial for survival.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Immunology

Background:

  • Histoplasmosis, a systemic mycosis caused by Histoplasma capsulatum, presents variably from asymptomatic to disseminated disease.
  • Disseminated histoplasmosis is particularly aggressive in individuals with advanced HIV/AIDS and low CD4 counts (<150 cells).
  • Initial symptoms are nonspecific (fever, weight loss, cough), and skin manifestations can be diverse.

Observation:

  • A case of a 33-year-old male with advanced HIV/AIDS (C3), pulmonary tuberculosis, and dermatosis is presented.
  • The patient had a history of poor treatment adherence over 9 months.
  • The patient died due to complications arising from disseminated histoplasmosis.

Findings:

  • Disseminated histoplasmosis requires a high index of suspicion in HIV-infected patients.
  • Differential diagnosis must include other common opportunistic infections like pulmonary tuberculosis.
  • Poor adherence to treatment significantly increases mortality risk.

Implications:

  • Histoplasmosis is a critical opportunistic infection in advanced HIV/AIDS, especially in endemic regions.
  • Early diagnostic protocols and patient education on treatment adherence are vital.
  • Prompt recognition and management can mitigate the high mortality associated with disseminated histoplasmosis.
Keywords:
Acquired Immunodeficiency SyndromeHIVHistoplasmosis

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