title: Histoplasma capsulatum Infection with Extensive Lytic Bone Lesions Mimicking LCH.
abstract: Multiple lytic bone lesions in a child can be a manifestation of various diseases like Langerhans cell histiocytosis, metastatic neuroblastoma, leukemia, hyperparathyroidism, multifocal osteomyelitis and histoplasmosis. Disseminated histoplasmosis caused by Histoplasma capsulatum var. duboisii is well known to present with multiple osteolytic lesions in immunocompromised adults and is mostly restricted to the African subcontinent. Histoplasmosis seen in American and Asian countries is caused by Histoplasma capsulatum var. capsulatum, which presents with pulmonary and systemic manifestations and rarely bone involvement. We report a case of histoplasmosis, caused by H. capsulatum var. capsulatum with extensive lytic bone lesions in a 13 year old immunocompetent boy who presented with prolonged fever, weight loss and multiple boggy swellings. He responded to amphotericin and is currently on Itraconazole. This case is unique for extensive osteolytic lesions with H. capsulatum var. capsulatum infection in an immunocompetent child.
authors.affiliation: Department of Pediatrics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India divyamathews82@gmail.co.
authors.forename: Divya Mariam
authors.initials: DM
authors.lastname: Mathews
authors.affiliation: Department of Pediatrics Haematology-Oncology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Rikki
authors.initials: R
authors.lastname: John
authors.affiliation: Department of Pediatrics Infectious Diseases, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Valsan
authors.initials: V
authors.lastname: Verghese
authors.affiliation: Department of Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Harshad
authors.initials: H
authors.lastname: Parmar
authors.affiliation: Department of Pediatrics Haematology-Oncology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Narendra
authors.initials: N
authors.lastname: Chaudhary
authors.affiliation: Department of Pediatrics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Sataroopa
authors.initials: S
authors.lastname: Mishra
authors.affiliation: Department of Pediatrics Haematology-Oncology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Leni
authors.initials: L
authors.lastname: Mathew
mesh_terms: D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use; D005334:Fever / Q000209:etiology; D006658:Histoplasma / Q000145:classification / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007121:Immunocompetence; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B
keywords: H. capsulatum var. capsulatum; immunocompetent child; osteolytic lesions