title: Histoplasmosis and subcutaneous nodules in a kidney transplant recipient: erythema nodosum versus fungal panniculitis.
abstract: Erythema nodosum (EN)-like lesions are a rare occurrence after solid organ transplantation. Differential diagnosis includes infective panniculitis, which can be a feature of progressive disseminated histoplasmosis (PDH), an uncommon but severe form affecting primarily immunocompromised hosts. We report on a fatal case of PDH, which presented as fungal panniculitis masquerading as EN in a renal allograft recipient 25 years after transplantation. We discuss the clinical, histopathological, and microbiological characteristics of this rare complication, with focus on its distinction from EN. This case emphasizes the central role of biopsy in transplant recipients presenting with cutaneous lesions, and the importance of clinicopathologic correlation and complementary microbiological investigations.
authors: Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
authors: S F
authors: SF
authors: Dufresne
authors: R E
authors: RE
authors: LeBlanc
authors: S X
authors: SX
authors: Zhang
authors: K A
authors: KA
authors: Marr
authors: D
authors: D
authors: Neofytos
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004893:Erythema Nodosum / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D017809:Fatal Outcome; D005260:Female; D006658:Histoplasma / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000209:etiology*; D006801:Humans; D016030:Kidney Transplantation; D008875:Middle Aged; D015434:Panniculitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents