[Histoplasmosis mimicking tuberculosis spondylodiscitis in a patient with rheumatoid arthritis].
Osteoarticular infection caused by lt i gt Histoplasma capsulatum lt i gt is rare in Rheumatoid Arthritis (RA) making its diagnosis difficult. In the immunocompetent individuals this infection is autolimited or localized, while in immunodepressed patients the infection may be disseminated, and represents the reactivation of latent focuses or exogenous acquisition. Fungemia occurs in 20% of the cases; bones and joints are involved in 15%, being the spine the most common site of infection. We describe a clinical case of a woman with RA and spondylodiscitis caused by Histoplasma capsulatum with an initial diagnosis of vertebral tuberculosis. The complications of the treatment with amphotericin B, such as, vomiting and severe hypokalemia, led to several interruptions in the medication causing the spread of the pathogen into the liver and lungs.
Serviço de Reumatologia do Hospital Universitário Getúlio Vargas (HUGV), Universidade Federal do Amazonas (UFAM).
Simora Souza
SS
de Morais
Mayara de Oliveira
Mde O
Mafra
Elisângela Manara
EM
Canterle
Livia Lima
LL
de Lima
Sandra Lúcia Euzébio
SL
Ribeiro
D001172:Arthritis, Rheumatoid / Q000150:complications*; D003937:Diagnosis, Differential; D015299:Discitis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D005260:Female; D006660:Histoplasmosis / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D014399:Tuberculosis, Spinal / Q000175:diagnosis*
Histoplasma capsulatum simulando espondilodiscite tuberculose em doente com Artrite Reumatóide.