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Cutaneous histoplasmosis in a child with hyper-IgM

G G Yilmaz1, E Yilmaz, M Coşkun

  • 1Department of Pediatrics, Akdeniz University, Medical Faculty, Antalya, Turkey.

Pediatric Dermatology
|September 1, 1995
PubMed
Summary

Hyper-IgM disease, a rare immunodeficiency, can lead to severe infections. This report details the first case of cutaneous histoplasmosis in a child with this condition, successfully treated with antifungal medication.

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Area of Science:

  • Immunology
  • Mycology
  • Dermatology

Background:

  • Immunodeficiency with hyperimmunoglobulinemia M (Hyper-IgM) is a rare primary immunodeficiency characterized by low IgG/IgA and normal/high IgM/IgD levels.
  • Patients with Hyper-IgM are susceptible to severe bacterial infections, necessitating immunoglobulin replacement therapy.
  • Histoplasmosis is a systemic fungal infection caused by Histoplasma capsulatum, typically affecting the reticuloendothelial system.

Observation:

  • Cutaneous histoplasmosis, a rare manifestation, usually occurs in immunocompromised individuals, such as those with advanced HIV.
  • A 5-year-old boy with Hyper-IgM presented with a granulomatous skin lesion.
  • The patient was diagnosed with cutaneous histoplasmosis and a granulomatous reaction.

Findings:

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  • This is the first reported case of cutaneous histoplasmosis occurring in a patient with Hyper-IgM disease.
  • The patient's skin lesions showed improvement following oral ketoconazole therapy.

    • Implications:

    • This case highlights the potential for unusual opportunistic infections in patients with Hyper-IgM.
    • Early diagnosis and treatment of cutaneous manifestations are crucial for managing patients with primary immunodeficiencies.
    • Further research may elucidate the specific immune defects in Hyper-IgM that predispose to fungal skin infections.