Disseminated Histoplasmosis in a 13-year-old girl: A case report

AC Ubesie, OC Okafo, NS Ibeziako, VO Onukwuli, NR Mbanefo, JC Uzoigwe, C Bede, BC Ibe

Abstract

Background: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immunecompromised individuals such as those with acquired immuno-deficiency syndrome.

Objective: To describe a case of disseminated histoplasmosis in an adolescent girl.

Method: We report a case of disseminated histoplasmosis in a 13-year-old adolescent girl. She was admitted for 16 days because of neck masses of 3 years duration, generalized body swelling of 3 months and reduction in urinary output of 2 months. She tested negative for human immunodeficiency virus antibodies.

Result: An autopsy was performed because a definitive diagnosis could not be made while the patient was still alive. The autopsy revealed central caseating areas in the lymph nodes and membranoproliferative  glomerulonephritis. The periodic acid-Schiff staining technique for tissues showed viable yeast cells suggestive of histoplasmosis. Zeihl-Neelsen’s staining for mycobacteria tuberculosis was negative.

Conclusion: Undiagnosed case of disseminated histoplasmosis while the patient was alive is being reported in a 13-yearold girl. Disseminated histoplasmosis should be considered as a differential diagnosis of  childhood chronic infections and malignancies as in Nigeria.

Key words: Disseminated histoplasmosis, immune-competent, adolescent girl, Enugu