Progressive disseminated histoplasmosis in systemic lupus erythematosus-an unusual presentation of acute tenosynovitis and a literature review.
Progressive disseminated histoplasmosis is a disease where Histoplasma capsulatum affects multiple organs due to the inability of host cellular immunity to control the infection. Progressive disseminated histoplasmosis mainly involves the bone marrow, liver, and lungs. We report an unusual initial presentation of progressive disseminated histoplasmosis presenting as acute tenosynovitis in a systemic lupus erythematosus (SLE) patient. This report highlights the point that H. capsulatum may present as focal lesions and a high level of suspicion is needed to make the diagnosis, especially in SLE patients. We specifically reviewed reported cases of progressive disseminated histoplasmosis in SLE patients, and a review of the literature is presented.
Department of Internal Medicine, Texas Tech University Health Science Center, 3601 4th Street, Lubbock, TX 79430, USA. limsianyik@gmail.com
Sian Yik
SY
Lim
Kunut
K
Kijsirichareanchai
Richard
R
Winn
D000208:Acute Disease; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001853:Bone Marrow / Q000382:microbiology / Q000473:pathology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D006658:Histoplasma / Q000302:isolation & purification; D006660:Histoplasmosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008099:Liver / Q000382:microbiology / Q000473:pathology; D008168:Lung / Q000382:microbiology / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013717:Tenosynovitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy
D000935:Antifungal Agents; D017964:Itraconazole