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Case Reports
. 2020 Nov 10;6(4):275.
doi: 10.3390/jof6040275.

Coronavirus Disease 2019 (COVID-19) in a Patient with Disseminated Histoplasmosis and HIV-A Case Report from Argentina and Literature Review

Fernando A Messina  1 , Emmanuel Marin  1 , Diego H Caceres  2   3 , Mercedes Romero  1 , Roxana Depardo  1 , Maria M Priarone  4 , Laura Rey  5 , Mariana Vázquez  6 , Paul E Verweij  3 , Tom M Chiller  2 , Gabriela Santiso  1
Affiliations
Case Reports

Coronavirus Disease 2019 (COVID-19) in a Patient with Disseminated Histoplasmosis and HIV-A Case Report from Argentina and Literature Review

Fernando A Messina et al. J Fungi (Basel). .

Abstract

The disease caused by the new SARS-CoV-2, known as Coronavirus disease 2019 (COVID-19), was first identified in China in December 2019 and rapidly spread around the world. Coinfections with fungal pathogens in patients with COVID-19 add challenges to patient care. We conducted a literature review on fungal coinfections in patients with COVID-19. We describe a report of a patient with disseminated histoplasmosis who was likely infected with SARS-CoV-2 and experienced COVID-19 during hospital care in Buenos Aires, Argentina. This patient presented with advanced HIV disease, a well-known factor for disseminated histoplasmosis; on the other hand, we suspected that COVID-19 was acquired during hospitalization but there is not enough evidence to support this hypothesis. Clinical correlation and the use of specific Histoplasma and COVID-19 rapid diagnostics assays were key to the timely diagnosis of both infections, permitting appropriate treatment and patient care.

Keywords: COVID-19; Coronavirus; Histoplasma; Histoplasmosis.

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Conflict of interest statement

The authors declare no conflict of interest. The findings and the conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Figures

Figure 1
Figure 1
Clinical findings: (A,B) Papule-like lesions in the right malar region and in the proximal area of the nose and erythematous lesion with slight central ulceration in the central palate. (C) Chest computed tomography (CT), without contrast, revealed a bilateral and diffuse micronodular interstitial pattern, compatible with miliary histoplasmosis. (D) Wright-Giemsa stain on sputum smear, intracellular clusters of budding yeast compatible with H. capsulatum using Wright-Giemsa stain.
Figure 2
Figure 2
Case timeline: Coronavirus disease 2019 (COVID-19) in a patient with progressive disseminated histoplasmosis from Argentina.
Figure 3
Figure 3
Follow-up using Histoplasma antigen testing in a patient with disseminated histoplasmosis and COVID-19.
See this image and copyright information in PMC

References

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    1. Mahony J.B., Zhang C. Manual of Molecular and Clinical Laboratory Immunology. 7th ed. ASM Press; Washington, DC, USA: 2006. Coronavirus Including Severe Acute Respiratory Syndrome (SARS) pp. 803–809. - DOI
    1. Kimberlin D.W., Brady M.T., Jackson M.A., Long S.S., editors. Red Book: 2018 Report of the Committee on Infectious Diseases. American Academy of Pediatrics; Washington, DC, USA: 2018. Coronaviruses, Including SARS and MERS; pp. 297–301.
    1. WHO Severe Acute Respiratory Syndrome (SARS) [(accessed on 9 November 2020)]; Available online: https://www.who.int/health-topics/severe-acute-respiratory-syndrome#tab=....
    1. CDC Middle East Respiratory Syndrome (MERS) [(accessed on 2 August 2019)]; Available online: https://www.cdc.gov/coronavirus/mers/index.html.

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