Disseminated histoplasmosis presenting as pyoderma gangrenosum‐like ulcers in an apparently immunocompetent patient: multiple red herrings presenting a diagnostic challenge

2020 ◽  
Vol 59 (9) ◽  
Author(s):  
Vishal Gupta ◽  
Saurabh Bhatia ◽  
Pankhuri Dudani ◽  
Sudheer Arava ◽  
Naren Hemachandran ◽  
...  
Author(s):  
Esfandiar Shojaei ◽  
Joanna C Walsh ◽  
Nikhil Sangle ◽  
Brian Yan ◽  
Michael S Silverman ◽  
...  

Abstract Disseminated histoplasmosis is a life-threatening disease usually seen in immunocompromised patients living in endemic areas. We present an apparently immunocompetent patient with gastrointestinal histoplasmosis who was initially diagnosed as biopsy-proven Crohn’s disease. Following discontinuation of anti-inflammatory drugs and institution of antifungal therapy, his GI illness completely improved. Specific fungal staining should be routinely included in histopathologic assessment of tissue specimens diagnosed as Crohn’s disease.


2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Debopriya Chatterjee ◽  
Aishwarya Chatterjee ◽  
Manoj Agarwal ◽  
Meetu Mathur ◽  
Setu Mathur ◽  
...  

A case of disseminated histoplasmosis (DH) in a 60-year-old female patient is reported from Jaipur, Rajasthan, India. The patient presented with multiple papules on the skin surrounding the lips, face, torso, trunk, and back. She also complained of growth in the palate. Histoplasmosis was confirmed by biopsy and histopathology of skin and palatal lesions. This case report highlights the presenting features and occurrence of histoplasmosis in nonendemic region in India.


2021 ◽  
Vol 54 (3) ◽  
pp. 111
Author(s):  
Pranita Mohanty ◽  
Anasuya Lenka ◽  
T Govardhan ◽  
Souvagya Panigrahi

Cureus ◽  
2021 ◽  
Author(s):  
Matthew Taylor ◽  
Arjun Ghodasara ◽  
Ali Ismail ◽  
Umair Gauhar ◽  
Karim El-Kersh

2021 ◽  
Vol 14 (3) ◽  
pp. e236892
Author(s):  
Mark Brahier ◽  
Rhanika Neuda ◽  
William Davis ◽  
Rita Poon

Medical tourism is the pursuit of more affordable surgeries; however, this comes at the risk of suboptimal standards and potential for life-threatening complications. In this case, we describe the diagnostic challenge of cytomegalovirus (CMV) pneumonia in a 40-year-old woman who experienced wound dehiscence and subsequent blood transfusion-transmitted CMV as complications of liposuction in the Dominican Republic. We explore the role of histopathology in the diagnosis of disseminated CMV, discuss the underlying aetiology of CMV pneumonia in this patient and weigh the risks and benefits of initiating antiviral therapy in an immunocompetent patient with CMV disease.


2017 ◽  
pp. bcr2016217915 ◽  
Author(s):  
Negin Niknam ◽  
Prashant Malhotra ◽  
Angela Kim ◽  
Seth Koenig

2018 ◽  
Vol 6 ◽  
pp. 2050313X1878304 ◽  
Author(s):  
Mildred Lopez Pineiro ◽  
Eric Willis ◽  
Chen Yao ◽  
Susan Y Chon

Sunitinib is a multi-targeted receptor tyrosine kinase inhibitor used for the treatment of multiple different types of malignancies. Serious grade 3–4 adverse events occur in <10% of the patient population and usually improve with dose reduction. One of the more rarely reported side effects of sunitinib therapy is the development of pyoderma gangrenosum–like ulcerations in the lower extremities. These pyoderma gangrenosum–like ulcerations are difficult to treat and distinguish from similar-appearing dermatological diagnoses. We present a patient with refractory lung carcinoma and a past medical history of squamous cell carcinoma of the lower extremity, who developed a non-healing ulceration at the previous site of her skin cancer while undergoing therapy with sunitinib. At the time of the initial evaluation, the ulceration mimicked recurrent squamous cell carcinoma, posing a diagnostic challenge. Histopathological findings showed epidermal hyperplasia, ulceration, and dense acute inflammation. Despite meticulous wound care and treatment of infection, the ulcer only improved with cessation of sunitinib.


2017 ◽  
Vol 45 (9) ◽  
pp. 848-850
Author(s):  
Manju Kumari ◽  
Madhumitha Udayakumar ◽  
Manju Kaushal ◽  
Garima Baweja Madaan

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Prasan K. Panda ◽  
Siddharth Jain ◽  
Rita Sood ◽  
Rajni Yadav ◽  
Naval K. Vikram

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.


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