title: Unmasking histoplasmosis immune reconstitution inflammatory syndrome in a patient recently started on antiretroviral therapy.
abstract: Histoplasmosis is the most common endemic mycoses among HIV-infected people. Patients with suppressed cell immunity mainly due to HIV are at increased risk of disseminated disease. Dermatological manifestations of immune reconstitution inflammatory syndrome (IRIS) and cutaneous manifestations of histoplasmosis similar to an IRIS event have been previously described. We report the case of a 43-year-old male who presented with cutaneous disseminated histoplasmosis due toHistoplasma capsulatumvar.capsulatum4 months after the onset of the antiretroviral therapy and some improvement in the immune reconstitution. After 2 weeks of amphotericin B and itraconazole therapy, the scheduled treatment involved fluconazole maintenance therapy, which resulted in an improvement of his skin lesions.
authors.affiliation: College of Health Sciences - Infectious Disease Institute - Makerere University, Kampala - Uganda .
authors.forename: Reuben
authors.initials: R
authors.lastname: Kiggundu
authors.affiliation: College of Health Sciences - School of Medicine - Makerere University, Kampala - Uganda .
authors.forename: Henry W
authors.initials: HW
authors.lastname: Nabeta
authors.affiliation: College of Health Sciences - School of Medicine - Makerere University, Kampala - Uganda .
authors.forename: Richard
authors.initials: R
authors.lastname: Okia
authors.affiliation: College of Health Sciences - Infectious Disease Institute - Makerere University, Kampala - Uganda.; Department of Medicine - University of Minnesota, Minneapolis/MN - USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Rhein
authors.affiliation: College of Health Sciences - School of Biomedical Sciences - Makerere University, Kampala - Uganda .
authors.forename: Robert
authors.initials: R
authors.lastname: Lukande
keywords: Antiretroviral Therapy, Highly Active, Fluconazole; Histoplasmosis; Immune Reconstitution Inflammatory Syndrome