Left hand extensor tenosynovitis due to <i>Histoplasma capsulatum</i> complicated by immune reconstitution inflammatory syndrome

Abstract

We describe a case of left hand extensor tenosynovitis due to histoplasmosis in a patient with dermatomyositis on chronic immunosuppression. Treatment involved surgical debridement and antifungal therapy. The patient experienced paradoxical worsening of tenosynovial inflammation during de-augmentation of immunosuppression felt to be immune reconstitution inflammatory syndrome.