Taylor Matthew, Ghodasara Arjun, Ismail Ali, Gauhar Umair, El-Kersh Karim
Pulmonary and Critical Care, University of Louisville, Louisville, USA.
Pathology and Laboratory Medicine, University of Louisville, Louisville, USA.
Cureus. 2021 Aug 18;13(8):e17269. doi: 10.7759/cureus.17269. eCollection 2021 Aug.
Disseminated histoplasmosis can occur in immunocompromised patients such as in HIV disease and patients with medication-induced immunosuppression. Most of these patients present with fever, weight loss, hepatosplenomegaly, lymphadenopathy, and pancytopenia. There are increasing reports of coronavirus disease 2019 (COVID-19) pneumonia associated with fungal infections including aspergillus and mucormycosis. It is not typical for immunocompetent patients to present with disseminated fungal disease. We herein report a case of a 50-year-old immunocompetent male with a recent recovery from COVID-19 pneumonia who presented with fever and pancytopenia. Chest computed tomography (CT) demonstrated new-onset right upper lobe lung mass, subcarinal lymphadenopathy, and splenomegaly. Mediastinal lymph nodes and bone marrow biopsies were performed, and the patient was diagnosed with disseminated histoplasmosis. The association between COVID-19 pneumonia and fungal infections is increasingly reported. Diagnosis requires a high index of suspicion, especially in immunocompetent patients.
播散性组织胞浆菌病可发生于免疫功能低下的患者，如患有人类免疫缺陷病毒（HIV）疾病的患者以及药物诱导免疫抑制的患者。这些患者大多表现为发热、体重减轻、肝脾肿大、淋巴结病和全血细胞减少。越来越多的报告称，2019冠状病毒病（COVID-19）肺炎与包括曲霉和毛霉菌病在内的真菌感染有关。免疫功能正常的患者出现播散性真菌病并不常见。我们在此报告一例50岁免疫功能正常的男性病例，该患者近期从COVID-19肺炎中康复，出现发热和全血细胞减少。胸部计算机断层扫描（CT）显示新发右上叶肺部肿块、隆突下淋巴结病和脾肿大。进行了纵隔淋巴结和骨髓活检，该患者被诊断为播散性组织胞浆菌病。COVID-19肺炎与真菌感染之间的关联报告越来越多。诊断需要高度怀疑，尤其是在免疫功能正常的患者中。
