Marzukie, Marsilla Mariaty and Ahmad Affandi, Khairunisa and Yahaya, Azyani and Periyasamy, Petrick
(2019)
Disseminated histoplasmosis mimicking an acute appendicitis.
Malaysian Journal of Pathology, 41 (2).
pp. 223-227.
ISSN 0126-8635
Abstract
Introduction: Histoplasmosis can present in a myriad of clinical manifestations, which often makes
its diagnosis difficult and occasionally, deceptive. Case Report: We describe a case of a 33 years
old gentleman who was clinically diagnosed as acute appendicitis at initial presentation in view
of a one-week history of fever, right lower quadrant abdominal pain- and guarding at right iliac
fossa. He had thrombocytopenia and lymphopenia on presentation. Mesenteric lymphadenitis and
small bowel lesion were found intraoperatively, which was respectively biopsied and resected.
Histopathological result confirms disseminated histoplasmosis. Retroviral screen was positive. He
was treated with amphotericin B for one week, subsequently switched to oral itraconazole, followed
by initiation of highly active antiretroviral therapy (HAART). Discussion: This case illustrates the
various nature of histoplasmosis presentation. A high index of suspicion is needed to clinch the
diagnosis and subsequently institute prompt treatment as disseminated disease can be fatal if left
untreated in an immunosuppressed host.
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