摘要
Rationale:Disseminated histoplasmosis is the most severe form of histoplasmosis and often associated with fatal outcomes.Both pulmonary and disseminated forms mimics tuberculosis(TB)and may be misdiagnosed.Patient concerns:A 17-year-old male patient compliant with anti-tuberculosis therapy with complaints of fever,cough productive of thick yellowish sputum,fast breathing,abdominal pain,swelling and jaundice.HIV status was negative.Diagnosis:Disseminated histoplasmosis.Interventions:Antimicrobials including anti-TB therapy,ceftriaxone,gentamicin,azithromycin and ciprofloxacin.Outcomes:He was responding to anti-TB drugs until about 4 and a half months on treatment when he fell ill.Peripheral blood film done 2 days prior to his demise revealed florid yeast like organisms in monocytes with eccentric chromatin suggestive of Histoplasma capsulatum.Lessons:Histoplasmosis can both mimic and coexist with TB and so a high index of suspicion is needed for its diagnosis.
