Kiruba Devi G Anu, Rajamohanan Remya Raj, Sakkaravarthi Vinupriya, Toi Pampa Ch, Munisamy Malathi
Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Kalapet, Puducherry, India.
Department of Dermatology, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India.
Indian J Sex Transm Dis AIDS. 2022 Jul-Dec;43(2):203-205. doi: 10.4103/ijstd.ijstd_45_21. Epub 2022 Nov 17.
Histoplasmosis has heterogenous clinical presentation ranging from mild and self-limiting respiratory disease to disseminated forms with high mortality. In progressive disseminated histoplasmosis (PDH), patient presents with fever, lymphadenopathy, hepatosplenomegaly, adrenal enlargement, hemophagocytic lymphohistiocytosis and non-specific mucocutaneous lesions, usually in late stage of HIV. Cutaneous involvement is upto 25% in PDH which are papules, plaques, nodules and ulcers. Forty-two year old male, recently diagnosed as HIV positive presented with complaints of multiple painful ulcerated lesions over face, neck, tongue, arms, trunk & genitalia. Skin Biopsy was suggestive of histoplasmosis. Patient showed excellent response with amphotericin B and itraconazole. Since histoplasmosis is relatively uncommon, there should be a high-index of suspicion when an HIV patient presents with disseminated skin lesions.
组织胞浆菌病临床表现多样，从轻度自限性呼吸道疾病到死亡率高的播散型疾病。在进行性播散性组织胞浆菌病（PDH）中，患者通常在HIV晚期出现发热、淋巴结病、肝脾肿大、肾上腺增大、噬血细胞性淋巴组织细胞增生症和非特异性黏膜皮肤病变。皮肤受累在PDH中高达25%，表现为丘疹、斑块、结节和溃疡。一名42岁男性，最近被诊断为HIV阳性，主诉面部、颈部、舌头、手臂、躯干和生殖器出现多处疼痛性溃疡病变。皮肤活检提示为组织胞浆菌病。患者使用两性霉素B和伊曲康唑后反应良好。由于组织胞浆菌病相对不常见，当HIV患者出现播散性皮肤病变时，应高度怀疑。
