Gupta Harshit, Yadav Kl Pradeep, Totaganti Manjunath, Kant Ravi, Monica Devi Yumkham
Internal Medicine, All India Institute of Medical Sciences, Rishikesh, IND.
Internal Medicine, Sri Siddhartha Medical College, Tumkur, IND.
Cureus. 2023 Mar 18;15(3):e36333. doi: 10.7759/cureus.36333. eCollection 2023 Mar.
We report a case of Histoplasma-associated hemophagocytic syndrome in a diabetes mellitus patient. The patient presented with a fever, cough, and an ulcer on the tongue. The biopsy confirmed the diagnosis of histoplasmosis from the tongue ulcer. Other investigations revealed normal clusters of differentiation 4 (CD4) count and increased hemoglobin A1c (HbA1c) and lactate dehydrogenase (LDH) levels. The patient was diagnosed with hemophagocytic syndrome secondary to Histoplasma after fulfilling the hemophagocytic lymphohistiocytosis (HLH)-2004 criteria required for diagnosis, including fever (with peak temperatures of >38.5° C), splenomegaly, cytopenia affecting two cell lineages in peripheral blood, hypertriglyceridemia (fasting triglycerides >265 mg/dL), and hemophagocytosis in the bone marrow biopsy. The patient was started on injection amphotericin B with remarkable improvement.
我们报告了一例糖尿病患者并发组织胞浆菌相关性噬血细胞综合征的病例。该患者出现发热、咳嗽和舌部溃疡。活检证实舌部溃疡为组织胞浆菌病。其他检查显示分化簇4（CD4）计数正常，糖化血红蛋白（HbA1c）和乳酸脱氢酶（LDH）水平升高。该患者在满足噬血细胞性淋巴组织细胞增生症（HLH）-2004诊断标准后，被诊断为继发于组织胞浆菌的噬血细胞综合征，这些标准包括发热（最高体温>38.5°C）、脾肿大、外周血中影响两个细胞系的血细胞减少、高甘油三酯血症（空腹甘油三酯>265mg/dL）以及骨髓活检中的噬血细胞现象。患者开始接受两性霉素B注射治疗，病情有显著改善。
