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Miliary Histoplasmosis in a Patient with Rheumatoid Arthritis
Joint Authors
Abidi, Maheen Z.
McCollister, Bruce D.
Lum, Jessica
Henao-Martínez, Andrés F.
Source
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-04-16
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Miliary histoplasmosis is a rare presentation that may mimic miliary tuberculosis.
We report a case of miliary histoplasmosis in a 52-year-old male who was being treated with hydroxychloroquine, methotrexate, and sulfasalazine for his rheumatoid arthritis and presented to the emergency department with shortness of breath and fevers.
Computed tomography (CT) chest revealed miliary pulmonary nodules.
Urine Histoplasma antigen and serum Histoplasma antigen were negative; however, Coccidioides immitis complement immunofixation assay and Coccidioides IgM were positive.
The patient was initiated on treatment for pulmonary coccidioidomycosis and immunosuppression was held.
However, a few days later, Histoplasma capsulatum was isolated from cultures from bronchoscopy.
This case highlights the difficulty in diagnosing histoplasmosis in immunocompromised patients and the importance of having a broad differential diagnosis for miliary pulmonary nodules.
Tissue culture and histopathology remain the gold standard for the diagnosis of histoplasmosis.
Further research needs to be conducted to determine the optimal duration of histoplasmosis treatment in immunocompromised patients.
American Psychological Association (APA)
Lum, Jessica& Abidi, Maheen Z.& McCollister, Bruce D.& Henao-Martínez, Andrés F.. 2018. Miliary Histoplasmosis in a Patient with Rheumatoid Arthritis. Case Reports in Medicine،Vol. 2018, no. 2018, pp.1-6.
https://search.emarefa.net/detail/BIM-1144820
Modern Language Association (MLA)
Lum, Jessica…[et al.]. Miliary Histoplasmosis in a Patient with Rheumatoid Arthritis. Case Reports in Medicine No. 2018 (2018), pp.1-6.
https://search.emarefa.net/detail/BIM-1144820
American Medical Association (AMA)
Lum, Jessica& Abidi, Maheen Z.& McCollister, Bruce D.& Henao-Martínez, Andrés F.. Miliary Histoplasmosis in a Patient with Rheumatoid Arthritis. Case Reports in Medicine. 2018. Vol. 2018, no. 2018, pp.1-6.
https://search.emarefa.net/detail/BIM-1144820
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1144820