Disseminated histoplasmosis in an apparently immunocompetent individual from north India: a case report and review

Abstract

Mucocutaneous histoplasmosis is frequently reported in patients with acquired immune deficiency syndrome (AIDS), but it is rare in immunocompetent hosts. Disseminated histoplasmosis involving skin and larynx in a 50-year-old immunocompetent male is described from a non-endemic area in India. The infection appeared to be imported from Thailand. The patient responded very well to intravenous amphotericin B followed by itraconazole. A review of all cases of histoplasmosis occurring in immunocompetent patients from India is reported. Most cases are reported from the Gangetic plains. Adrenals are the most common organ involved in immunocompetent patients, but adrenal insufficiency is not common. Skin lesions and oral ulcers are seen in more than one-third of patients. Predisposing factors like exposure to birds, farming, mining, diabetes were observed in few patients.