title: Typical Facial Lesions: A Window of Suspicion for Progressive Disseminated Histoplasmosis-A Case of Asian Prototype.
abstract: Histoplasmosis is caused by a dimorphic fungusHistoplasma capsulatumin endemic areas, mainly America, Africa, and Asia. In India, it is being reported from most states; however, it is endemic along the Ganges belt. We report a case of an apparently immunocompetent male who presented with 3-month history of fever, cough, and weight loss with recent onset odynophagia and had hepatosplenomegaly and mucocutaneous lesions over the face. The differential diagnosis of leishmaniasis, tuberculosis, leprosy, fungal infection, lymphoproliferative malignancy, and other granulomatous disorders was considered, but he succumbed to his illness. Antemortem skin biopsy and bone marrow aspiration along with postmortem liver, lung, and spleen biopsy showed disseminated histoplasmosis. This case highlights the need for an early suspicion of progressive disseminated histoplasmosis in the presence of classical mucocutaneous lesions even in an immunocompetent patient suffering from a febrile illness. Cure rate approaches almost 100% with early treatment, whereas it is universally fatal if left untreated.
authors.affiliation: Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Prasan K
authors.initials: PK
authors.lastname: Panda
authors.affiliation: Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Jain
authors.affiliation: Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Rita
authors.initials: R
authors.lastname: Sood
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Rajni
authors.initials: R
authors.lastname: Yadav
authors.affiliation: Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Naval K
authors.identifier: 0000-0002-6202-576X
authors.initials: NK
authors.lastname: Vikram