Disseminated histoplasmosis: a cause of infection-associated hemophagocytic syndrome.

PURPOSE

We report a case of infection-associated hemophagocytic syndrome in the setting of disseminated histoplasmosis.

PATIENTS AND METHODS

A 6-year-old boy with chronic mucocutaneous candidiasis developed a fulminant hemophagocytic syndrome. Evaluation for an infectious cause included bacterial, mycobacterial, viral, and fungal cultures, serological assessment, and histological examination of bone marrow and bronchoalveolar lavage fluid.

RESULTS

Culture of bone marrow aspirate, blood, and bronchoalveolar lavage showed disseminated histoplasmosis as the cause for this patient's hemophagocytic syndrome. The patient was treated with amphotericin B with complete resolution of his hemophagocytic syndrome.

CONCLUSIONS

Disseminated histoplasmosis is another cause of IAHS in children with an underlying immunodeficiency. Diagnostic difficulties associated with the hemophagocytic syndromes of childhood are discussed.