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Case Reports
. 2019 Jan 23:32:43.
doi: 10.11604/pamj.2019.32.43.14954. eCollection 2019.

Histoplasmosis, heart failure, hemolysis and haemophagocytic lymphohistiocytosis

Nitin Gupta  1 , Kutty Sharada Vinod  1 , Ankit Mittal  1 , Aswin Pius Ajay Kumar  1 , Arvind Kumar  1 , Naveet Wig  1
Affiliations
Case Reports

Histoplasmosis, heart failure, hemolysis and haemophagocytic lymphohistiocytosis

Nitin Gupta et al. Pan Afr Med J. .

Abstract

Histoplasmosis is an endemic mycosis with global distribution, primarily reported in immunocompromised individuals. A 29-year old immunocompetent male presented with fever, hepatosplenomegaly and pancytopenia. His peripheral blood showed features suggestive of intravascular hemolysis and echocardiography showed features suggestive of pulmonary arterial hypertension. Bone marrow showed yeast with morphology suggestive of Histoplasma capsulatum. Further investigations revealed hyperferritinemia, hypofibrinogenemia and increased triglycerides. With a diagnosis of progressive disseminated histoplasmosis with secondary Haemophagocytic lymphohistiocytosis, he was successfully treated with amphotericin B followed by itraconazole. We report this case to highlight the atypical and rare manifestations of histoplasmosis.

Keywords: Pulmonary arterial hypertension; immunocompetent; pancytopenia.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
ECG showing S1Q3T3 pattern
Figure 2
Figure 2
Bone marrow aspirate showing small extracellular cellular yeast cells with a false appearance of capsule around them
See this image and copyright information in PMC

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