A Rare Case of Disseminated Histoplasmosis in an Immunocompetent Young Male: Diagnostic Value of Bone Marrow Biopsy and Fungal Morphological Identification.

Abstract

The dimorphic fungus Histoplasma capsulatum causes histoplasmosis, an infection that can manifest as anything from a simple, self-limiting illness to a serious, widely spread illness. Fungal culture is still the gold standard for confirmation, but diagnosis is sometimes delayed by its slow development. Bone marrow analysis can offer a quick and accurate di-agnostic substitute in these situations. We describe a male immunocompetent patient, age 21, who has had a persistent fever and malaise for three months that have not improved with empirical treatment. Repeated blood cultures and sero-logic testing came out negative, but laboratory studies showed cytopenia. Grocott-Gomori Methenamine Silver (GMS) and Periodic acid–Schiff (PAS) stain, on the other hand, revealed intracellular and extracellular yeast-like organisms in bone marrow aspirate and trephine biopsy that were morphologically consistent with Histoplasma capsulatum.
Keywords: Histoplasma capsulatum, disseminated histoplasmosis, bone marrow biopsy, cytopenia, fungal morphology