Work

Disseminated Histoplasmosis as a Presentation of Advanced HIV-1 Infection in a Non-endemic Country

Year: 2025

Type: article

Abstract: Disseminated histoplasmosis is an opportunistic fungal infection considered an AIDS-defining illness, sometimes with a fatal outcome. We report a case of disseminated histoplasmosis as the initial presentation of advanced HIV-1 infection in a migrant living in a non-endemic area. Histoplasmosis was suspected based on the clinical presentation, epidemiological factors, and observation in the peripheral blood smear of neutrophils and monocytes with yeast-like forms. The diagnosis was confirmed through a positive peripheral blood smear and subsequent culture of Histoplasma capsulatum from a bronchoalveolar lavage sample. The patient was treated with 14 days of liposomal amphotericin B plus oral itraconazole for two years, with a good response. Direct examination of peripheral blood has been considered a valuable diagnostic method, specifically in severely immunocompromised patients, as our case report. The presented case highlights the importance of considering disseminated histoplasmosis in the differential diagnosis of HIV-infected patients, even in non-endemic regions. Hence, the need for a high index of suspicion to ensure early diagnosis and treatment is crucial as the influx of migrants increases globally.

Source: Cureus

DOI: 10.7759/cureus.78581

Authors: Débora A Alves, João Trêpa, José Sousa-Baptista, João Pereira-Vaz, Rui Tomé

Institutions: Unidade Local de Saúde de Coimbra, Unidade Local de Saúde de Viseu Dão-Lafões

Language: English

Topic: Fungal Infections and Studies

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4407165952