Chronic Disseminated Histoplasmosis

Abstract

A 55 year old HIV negative, controlled diabetic, male suffering from recurrent oropharyngeal ulcer for last 4 years, has recently developed papules and nodules predominantly on face and a few on upper trunk, arms and macrochilia for about last 3 months. Some papules resembled molluscum contagiosum. His palms showed significant erythema. Multiple ulcerative nodules were visible on tongue and buccal mucosa. Histopathology revealed intracellular yeast of Histoplasma capsulatum by PAS stain. The patient had no involvement of internal organs. He never traveled to endemic area but had exposure to a domestic ‘moina’ bird for last 6 years. The subject responded well to oral itraconazole 400 mg daily for 8 weeks followed by a maintenance therapy with 200 mg daily for another 8 weeks.