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. 2015 Jan 27;2(2):35-6.
doi: 10.1016/j.idcr.2015.01.003. eCollection 2015.

Disseminated Emmonsia in an HIV-HBV co-infected man

Arthur Mutyaba  1 , Mark W Sonderup  2 , Michael Locketz  3 , Ikechi Okpechi  1 , C Wendy Spearman  2 , Alan Tooke  1
Affiliations

Disseminated Emmonsia in an HIV-HBV co-infected man

Arthur Mutyaba et al. IDCases. .

Abstract

The differential diagnoses in patients with advanced HIV/AIDS presenting with fever and systemic illness is wide and warrants both infectious and non-infectious considerations. The need to make an early and accurate diagnosis is important to effect correct therapy and thus improve outcome. We describe a patient with several co-morbidities and an unusual disseminated fungal infection.

Keywords: Fungal infection; HIV; Hepatitis B; Maculopapular rash.

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Figures

Image 1
Image 1
Diffuse erythematous maculopapular rash.
Image 2
Image 2
Close-up view of skin rash noting central necrosis.
Image 3
Image 3
Needle biopsy of the liver showing ground-glass hepatocytes, microvesicular steatosis and haemosiderin pigment in Kupffer cells with minimal necroinflammatory activity (H&E; high power magnification).
Image 4
Image 4
Needle biopsy of the liver showing small fungal yeasts in the cytoplasm (arrow) of portal tract macrophages (PAS/diastase; high power magnification).
Image 5
Image 5
Skin punch biopsy showing nuclear debris from apoptotic neutrophils around a capillary in the superficial dermis (H&E; high power magnification).
Image 6
Image 6
Skin punch biopsy demonstrating small fungal yeasts with narrow-based budding present in the dermis (Grocott silver stain; high power magnification).
See this image and copyright information in PMC

References

    1. Kenyon C., Bonorchis K., Corcoran C., Meintjes G., Locketz M., Lehloenya R. A dimorphic fungus causing disseminated infection in South Africa. N Engl J Med. 2013;369(15):1416–1424. - PubMed
    1. Núñez M., Mendes-Correa M.C. Viral hepatitis and HIV: update and management. Antivir Ther. 2013;18(3 Pt B):451–458. - PubMed

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