Disseminated pulmonary histoplasmosis with multiple cutaneous lesions: Case report and literature review

Abstract

Histoplasmosis is the most prevalent endemic mycosis on the American continent. It is caused by the dimorphic fungi Histoplasma spp. The infection is acquired by inhaling microconidia. It regularly starts in the lungs and then spreads to different organs. Skin involvement only occurs in 10% of cases. We present the case of a patient with a history of alcoholism. The disease initially manifested with non-specific respiratory symptoms such as cough with bloody sputum, dyspnoea, fever and multiple skin lesions. Using the PAS (periodic acid–Schiff) and Grocott stain histochemical techniques, the skin biopsy revealed intracellular microorganisms with peripheral nuclei and perinuclear ring, identified as Histoplasma capsulatum. The spread of primary pulmonary histoplasmosis led to the presentation of skin lesions. Correct diagnosis and treatment in this case helped to reduce the high mortality of the disease.

Keywords

• Histoplasmosis
• Deep mycosis
• Immunosuppression
• Alcoholism