title: Histoplasmosis in Pleural Effusion in a 23-Year-Old Man With Mixed-Phenotype Acute Leukemia.
abstract: Histoplasmosis has been observed in patients with immunosuppression in the form of isolated pulmonary involvement and disseminated disease. However, very few cases of this type that involved pleural effusion have been reported, and none have been reported in a case individual with mixed-phenotype acute leukemia (MPAL). Herein, we report a case involving a 23 year old Punjabi man having fever and breathlessness in the postinduction therapy period for mixed-phenotype acute leukemia (MPAL) with diagnosis of histoplasmosis based on the results of pleural fluid cytologic testing. The diagnosis of histoplasmosis may be missed in routine pleural fluid cytology testing; however, a high degree of suspicion for opportunistic infections in patients with immunocompromised state can aid diagnosis.
authors.affiliation: Departments of Cytology and Gynaecologic Pathology.
authors.forename: Sudha
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Departments of Cytology and Gynaecologic Pathology.
authors.forename: Priya
authors.initials: P
authors.lastname: Singh
authors.affiliation: Internal Medicine and Clinical Hematology.
authors.forename: Kamal Kant
authors.initials: KK
authors.lastname: Sahu
authors.affiliation: Departments of Cytology and Gynaecologic Pathology.
authors.forename: Arvind
authors.initials: A
authors.lastname: Rajwanshi
authors.affiliation: Internal Medicine and Clinical Hematology.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Malhotra
authors.affiliation: Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Shano
authors.initials: S
authors.lastname: Naseem
mesh_terms: D000328:Adult; D006660:Histoplasmosis; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007938:Leukemia / Q000150:complications* / Q000188:drug therapy; D008297:Male; D009894:Opportunistic Infections; D010996:Pleural Effusion / Q000150:complications / Q000382:microbiology; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents
keywords: fluid cytology; histoplasma; immunocompromised host; mixed phenotype acute leukemia; opportunistic infection; pleural fluid