title: Granulomatous interstitial nephritis associated with disseminated histoplasmosis in an immunocompetent patient.
abstract: We present a case of a 64-year-old man with a prolonged history of fatigue, weight loss, fever, and kidney failure. Kidney biopsy showed severe granulomatous interstitial nephritis with numerous giant cells. Silver stains identified fungal micro-organisms consistent with Histoplasma species. Despite antifungal treatment, the patient died of overwhelming infection a few weeks later. This report emphasizes the importance of diagnosing histoplasmosis early. A high degree of suspicion is required to make the diagnosis of histoplasmosis in a case of granulomatous interstitial nephritis.
authors.affiliation: Division of Hypertension and Nephrology, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Qian
authors.forename: Hamid
authors.initials: H
authors.lastname: Humayun
authors.forename: Youshay
authors.initials: Y
authors.lastname: Humayun
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sethi
mesh_terms: D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006099:Granuloma / Q000150:complications* / Q000382:microbiology; D006660:Histoplasmosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007121:Immunocompetence; D007668:Kidney / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000473:pathology