Unusual presentations of disseminated histoplasmosis

Abstract

Histoplasmosis is considered to be the most prevalent endemic mycosis in United States that can present as a disseminated infection. The initial presentation of Disseminated Histoplasmosis (DH) can be atypical. We report three cases with such atypical presentation. Our first patient presented with bowel perforation, the second with left-sided pleural effusion and the third with submandibular abscess. Blood cultures as well as biopsy of perforation site, culture of pleural fluid and submandibular abscess were positive for Histoplasma Capsulatum (HC). We encourage clinicians to look for HC even in uncommon sites as dictated by the presenting symptoms and signs, especially in immunocompromised patients in endemic areas.