Disseminated histoplasmosis successfully treated with liposomal amphotericin B following azathioprine therapy in a patient from a nonendemic area.
Histoplasma infections in Europe are rare, and acute disseminated histoplasmosis has been observed only in immunocompromised persons. An unusual case of autochthonous disseminated histoplasmosis in a 22-year-old Spanish man who had been treated with azathioprine and prednisone for 4 weeks before admission is reported. The development of an acute form of the disease may represent an endogenous reactivation of a latent infection as a complication of immunosuppression resulting from the use of these drugs. This case illustrates the potential risk of this opportunistic fungal infection in patients receiving azathioprine therapy, an association that has been rarely described before.
Department of Internal Medicine, Hospital Costa del Sol, Marbella (Málaga), Spain.
F
F
Poveda
J
J
García-Alegría
M A
MA
de las Nieves
E
E
Villar
N
N
Montiel
A
A
del Arco
D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage* / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001379:Azathioprine / Q000009:adverse effects*; D001854:Bone Marrow Cells / Q000382:microbiology; D004337:Drug Carriers; D004359:Drug Therapy, Combination; D006658:Histoplasma / Q000302:isolation & purification; D006660:Histoplasmosis / Q000188:drug therapy*; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008081:Liposomes; D008198:Lymph Nodes / Q000382:microbiology; D008297:Male; D009894:Opportunistic Infections / Q000188:drug therapy*; D011241:Prednisone / Q000009:adverse effects
D000935:Antifungal Agents; D004337:Drug Carriers; D007166:Immunosuppressive Agents; D008081:Liposomes; D000666:Amphotericin B; D001379:Azathioprine; D011241:Prednisone