title: An Unusual Presentation of Disseminated Histoplasmosis: Case Report and Review of Pediatric Immunocompetent Patients from India.
abstract: Histoplasmosis is a progressive disease caused by dimorphic intracellular fungi and can prove fatal. Usually, it is present in immunocompromised individuals and immunocompetent individuals in the endemic zones. We report an unusual presentation of progressive disseminated histoplasmosis. The patient in the present case report was immunocompetent child and had fever, bone pains, gradual weight loss, lymphadenopathy and hepatosplenomegaly. Disseminated histoplasmosis (DH) was diagnosed on microscopic examination and fungal culture of bone marrow, blood, skin biopsy and lymph node aspirate. The patient died on seventh day of amphotericin B. In the absence of predisposing factors and classical clinical presentation of febrile neutropenia, lung, adrenal and oropharyngeal lesions, the disease posed a diagnostic challenge. Progressive disseminated histoplasmosis in children can be fatal despite timely diagnosis and therapy. In India, disseminated histoplasmosis is seen in immunocompetent hosts. All the pediatrics immunocompetent cases from India are also reviewed.
authors.affiliation: Department of Pathology, Safadarjung Hospital, Vardhmaan Mahavir Medical College, Delhi, India.
authors.forename: Poojan
authors.initials: P
authors.lastname: Agarwal
authors.affiliation: Department of Microbiology, Safadarjung Hospital, Vardhmaan Mahavir Medical College, C - 99, Neelambar Apartments, Opposite Sainik Vihar, Pitampura, Delhi, 110034, India. malinircapoor@gmail.com.
authors.forename: Malini R
authors.initials: MR
authors.lastname: Capoor
authors.affiliation: Department of Pathology, Safadarjung Hospital, Vardhmaan Mahavir Medical College, Delhi, India.
authors.forename: Mukul
authors.initials: M
authors.lastname: Singh
authors.affiliation: Department of Pediatrics, Safadarjung Hospital, Vardhmaan Mahavir Medical College, Delhi, India.
authors.forename: Arpita
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Pediatrics, Safadarjung Hospital, Vardhmaan Mahavir Medical College, Delhi, India.
authors.forename: Arini
authors.initials: A
authors.lastname: Chhakchhuak
authors.affiliation: Department of Pediatrics, Safadarjung Hospital, Vardhmaan Mahavir Medical College, Delhi, India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Debatta
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D002648:Child; D017809:Fatal Outcome; D005260:Female; D016469:Fungemia / Q000175:diagnosis* / Q000473:pathology*; D006658:Histoplasma / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007194:India
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B
keywords: Children; Complications; Disseminated histoplasmosis (DH); Immunocompetent hosts