title: An Unusual Cause of Fever, Generalized Lymphadenopathy and Eosinophilia in a HCV-Positive 6-Year-Old Boy.
abstract: A 6-year-old boy presented with a 3-month history of high-grade fever and night-sweats but without chills/rigors. On examination, he had moderate hepatosplenomegaly with multiple enlarged cervical and axillary lymph nodes. His hemogram revealed anemia and marked eosinophilia. Initial investigations were negative, except anti-HCV IgG antibodies, that were positive. Bone marrow aspirate showed a single histiocyte containing suspicious intracellular yeast-like forms. Cervical lymph node aspiration revealed a heavy load of intra- and extra-cellularHistoplasmaspp. Disseminated histoplasmosis remains an unusual cause of peripheral eosinophilia and diagnosis can often be rendered fairly easily by cytomorphological evaluation. The case illustrates how Indian pathologists must maintain a high index of suspicion for unexpected infectious disorders in cases with eosinophilia.
authors.affiliation: Pathology Group of Departments, Levels 4-5, Research Block A, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Hematology, Level 5, Research Block A, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India.
authors.forename: Prashant
authors.identifier: 0000-0003-4741-3403
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Department of Cytology and Gynecological Pathology, Level 4, Research Block A, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India.
authors.forename: Pranab
authors.initials: P
authors.lastname: Dey
authors.affiliation: Department of Gastroenterology (Paediatrics), Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India.
authors.forename: Babu Ram
authors.initials: BR
authors.lastname: Thapa
keywords: Bone marrow examination; Disseminated histoplasmosis; Eosinophilia; Fungal infection; Hepatitis C; Lymphadenopathy