title: [Histoplasmosis: uncommon opportunistic infection in a patient                     with HIV infection].
abstract: METHODS
  A 19-year-old HIV-positive man was admitted with fever of unknown origin and poor general condition. Antiretroviral therapy had been stopped by the patient eight months prior to admission.
  
  
  METHODS
  Laboratory tests revealed pancytopenia, high viral load and low count of T-helper cells (13/µl). Computer tomography of the thorax showed small patchy infiltrations. Extensive examinations (microbiology, laboratory tests, multiple investigations) revealed no pathogen. Liver biopsy proved disseminated histoplasmosis.
  
  
  METHODS
  Liposomal amphotericin B was started and switched to oral itraconazole after 14 days with itraconazole. With this treatment the patient condition improved and fever stopped. T-helper cells increased and the patient was discharged.
  
  
  CONCLUSIONS
  Disseminated histoplasmosis as an AIDS-defining opportunistic infection is uncommon (particularly as the patient had not been abroad in the last four years) and can be a life-threatening complication. Diagnosis must be confirmed by invasive methods especially in patients with compromised immune status and rapid clinical progression.
authors.affiliation: Gastroenterologie, Hepatologie und Endokrinologie, Innere Medizin I, Robert-Bosch-Krankenhaus, Stuttgart, Germany. Markus.Escher@rbk.de
authors.forename: M
authors.initials: M
authors.lastname: Escher
authors.forename: T M
authors.initials: TM
authors.lastname: Kainikkara
authors.forename: A
authors.initials: A
authors.lastname: Grabner
authors.forename: G
authors.initials: G
authors.lastname: Ott
authors.forename: E F
authors.initials: EF
authors.lastname: Stange
authors.forename: K R
authors.initials: KR
authors.lastname: Herrlinger
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D000666:Amphotericin B / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001706:Biopsy; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006660:Histoplasmosis / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007262:Infusions, Intravenous; D008099:Liver / Q000473:pathology; D008297:Male; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents; D000935:Antifungal Agents; D000666:Amphotericin B