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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 JMM+Case+Rep
2016 ; 3
(4
): e005035
Nephropedia Template TP
gab.com Text
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English Wikipedia
Progressive disseminated histoplasmosis mimicking a flare of systemic lupus
erythematosus: a European case report
#MMPMID28348765
van Doorn-Schepens ML
; Peters EJ
; van Vugt RM
; van der Spoel JI
; van Dijk K
JMM Case Rep
2016[Aug]; 3
(4
): e005035
PMID28348765
show ga
INTRODUCTION: Diagnosing progressive disseminated histoplasmosis (PDH) in
patients with systemic lupus erythematosus (SLE) is diagnostically challenging.
Since PDH is lethal when untreated, awareness of this infection in patients with
SLE is of utmost importance. To the best of our knowledge, this is the first
description of a case of PDH in a patient with SLE in Europe. CASE PRESENTATION:
A 56-year-old woman of Surinamese descent with a history of SLE, presented with
fever and polyarthritis. Although a flare of SLE was suspected initially,
cultures of bone marrow and broncho-alveolar lavage fluid grew Histoplasma
capsulatum. CONCLUSION: This case report highlights that physicians should be
aware of progressive disseminated histoplasmosis in patients with SLE treated
with immunosuppressive agents. The signs and symptoms can easily mimic a SLE
flare, which would then be treated with more aggressive immunosuppression.
Failure to recognize the infection will therefore invariably lead to death of the
patient. Progressive disseminated histoplasmosis is usually not recognized by
doctors in non-endemic areas such as Europe. However, globalisation and more
frequent intercontinental traffic of immunocompromised patients currently
increases the incidence of histoplasmosis in these areas. It is therefore of
life-saving importance that doctors are aware of the features of the infection in
areas where H. capsulatum is not endemic.