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Case Reports
. 2017 Jan;11(1):ED01-ED02.
doi: 10.7860/JCDR/2017/19676.9145. Epub 2017 Jan 1.

Primary Cutaneous Histoplasmosis Masquerading as Lepromatous Leprosy

Jenna Blah Bhattacharya  1 , Poonam Rani  1 , Radhika Aggarwal  2 , Seema Kaushal  3
Affiliations
Case Reports

Primary Cutaneous Histoplasmosis Masquerading as Lepromatous Leprosy

Jenna Blah Bhattacharya et al. J Clin Diagn Res. 2017 Jan.

Abstract

Histoplasmosis is a genus of dimorphic fungi having various varieties of which the commonest one causing infection is Histoplasma capsulatum known to cause histoplasmosis. It has a varied disease spectrum ranging from an acute infection to chronic disease especially in lungs, disseminated disease and cutaneous disorder. Histoplasma capsulatum usually causes subclinical infection and serious infections only manifest in immunocompromised patients. Frank cases of infection are seen in pulmonary histoplasmosis. The spores of these organisms are seen to be strongly associated with droppings of birds and bats. A combination of these droppings and some soil types provide for an excellent environment for the proliferation of spores. Pulmonary histoplasmosis and disseminated disease are very common in AIDS patients and are a great cause of morbidity and mortality in these patients. Primary cutaneous histoplasmosis is very rare and occurs due to penetrating injuries. Once diagnosis is made, the lesions respond very well to oral itraconazole, fluconazole or amphotericicn B. We report a rare case of Cutaneous Histoplasmosis (CHP) in a 70-year-old male with complaints of multiple nodules all over his body in a HIV seronegative and otherwise immunocompetent patient.

Keywords: Lepromatous leprosy; Mycotic infection; Nodulo-ulcerative lesions.

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Figures

[Table/Fig-1]:
[Table/Fig-1]:
Clinical photograph showing papulonodular skin lesions all over the face.
[Table/Fig-2]:
[Table/Fig-2]:
a) Slit skin smear examination showing multiple granulomas with many extracellular organisms of histoplasma capsulatum (inset; MGG 40X) lying in a background of inflammatory cells (MGG 20X); b) Showing a skin lined tissue with subepithelium showing multiple encapsulated organisms (arrow) lying singly and in clusters surrounded by inflammatory cells (H&E, 40X). (Images left to right)
[Table/Fig-3 a,b]:
[Table/Fig-3 a,b]:
Showing histoplasma capsulatum in silver methanamine 40X stain and Giemsa stain with inset showing the organism at 60X.
See this image and copyright information in PMC

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