Histoplasma capsulatum Infection with Extensive Lytic Bone Lesions Mimicking LCH

J Trop Pediatr. 2016 Dec;62(6):496-499. doi: 10.1093/tropej/fmw040. Epub 2016 Jun 20.

Abstract

Multiple lytic bone lesions in a child can be a manifestation of various diseases like Langerhans cell histiocytosis, metastatic neuroblastoma, leukemia, hyperparathyroidism, multifocal osteomyelitis and histoplasmosis. Disseminated histoplasmosis caused by Histoplasma capsulatum var. duboisii is well known to present with multiple osteolytic lesions in immunocompromised adults and is mostly restricted to the African subcontinent. Histoplasmosis seen in American and Asian countries is caused by Histoplasma capsulatum var. capsulatum, which presents with pulmonary and systemic manifestations and rarely bone involvement. We report a case of histoplasmosis, caused by H. capsulatum var. capsulatum with extensive lytic bone lesions in a 13 year old immunocompetent boy who presented with prolonged fever, weight loss and multiple boggy swellings. He responded to amphotericin and is currently on Itraconazole. This case is unique for extensive osteolytic lesions with H. capsulatum var. capsulatum infection in an immunocompetent child.

Keywords: H. capsulatum var. capsulatum; immunocompetent child; osteolytic lesions.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Amphotericin B / therapeutic use*
  • Antifungal Agents / therapeutic use
  • Fever / etiology
  • Histoplasma / classification
  • Histoplasma / isolation & purification*
  • Histoplasmosis / diagnosis*
  • Histoplasmosis / drug therapy
  • Humans
  • Immunocompetence*
  • Itraconazole / therapeutic use
  • Male
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Itraconazole
  • Amphotericin B