Histoplasmosis Presenting as Granulomatous Hepatitis: Case Report and Review of the Literature

Background. Histoplasma capsulatum is the most common endemic mycosis in the United States and is a frequent cause of opportunistic infection in immunodeficient hosts. Histoplasmosis is most often self-limiting and goes unrecognized in the immunocompetent population but can progress to disseminated...

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Main Authors:	Rihana, Nancy A., Kandula, Manasa, Velez, Ana, Dahal, Kumud, O'Neill, Edward B.
Format:	Online
Language:	English
Published:	Hindawi Publishing Corporation 2014
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070324/

id	pubmed-4070324
recordtype	oai_dc
spelling	pubmed-40703242014-07-10 Histoplasmosis Presenting as Granulomatous Hepatitis: Case Report and Review of the Literature Rihana, Nancy A. Kandula, Manasa Velez, Ana Dahal, Kumud O'Neill, Edward B. Case Report Background. Histoplasma capsulatum is the most common endemic mycosis in the United States and is a frequent cause of opportunistic infection in immunodeficient hosts. Histoplasmosis is most often self-limiting and goes unrecognized in the immunocompetent population but can progress to disseminated histoplasmosis in patients with an impaired immune system. Liver involvement as a part of disseminated histoplasmosis which usually originates in the lung is well known. However, extrapulmonary hepatic histoplasmosis as a primary manifestation is extremely rare. Case Presentation. We report a rare case of histoplasmosis that presented as persistent fever and abnormal liver function tests in a 66-year-old female with rheumatoid arthritis, receiving infliximab. Conclusion. Emphasizing histoplasmosis as a major cause of acute granulomatous hepatitis and fever of unknown origin in cell mediated immunodeficient population, this case highlights the need for high index of suspicion and the importance of prompt diagnosis since any delay of treatment can be life threatening in this population. Hindawi Publishing Corporation 2014 2014-06-09 /pmc/articles/PMC4070324/ /pubmed/25013413 http://dx.doi.org/10.1155/2014/879535 Text en Copyright © 2014 Nancy A. Rihana et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Rihana, Nancy A. Kandula, Manasa Velez, Ana Dahal, Kumud O'Neill, Edward B.
spellingShingle	Rihana, Nancy A. Kandula, Manasa Velez, Ana Dahal, Kumud O'Neill, Edward B. Histoplasmosis Presenting as Granulomatous Hepatitis: Case Report and Review of the Literature
author_facet	Rihana, Nancy A. Kandula, Manasa Velez, Ana Dahal, Kumud O'Neill, Edward B.
author_sort	Rihana, Nancy A.
title	Histoplasmosis Presenting as Granulomatous Hepatitis: Case Report and Review of the Literature
title_short	Histoplasmosis Presenting as Granulomatous Hepatitis: Case Report and Review of the Literature
title_full	Histoplasmosis Presenting as Granulomatous Hepatitis: Case Report and Review of the Literature
title_fullStr	Histoplasmosis Presenting as Granulomatous Hepatitis: Case Report and Review of the Literature
title_full_unstemmed	Histoplasmosis Presenting as Granulomatous Hepatitis: Case Report and Review of the Literature
title_sort	histoplasmosis presenting as granulomatous hepatitis: case report and review of the literature
description	Background. Histoplasma capsulatum is the most common endemic mycosis in the United States and is a frequent cause of opportunistic infection in immunodeficient hosts. Histoplasmosis is most often self-limiting and goes unrecognized in the immunocompetent population but can progress to disseminated histoplasmosis in patients with an impaired immune system. Liver involvement as a part of disseminated histoplasmosis which usually originates in the lung is well known. However, extrapulmonary hepatic histoplasmosis as a primary manifestation is extremely rare. Case Presentation. We report a rare case of histoplasmosis that presented as persistent fever and abnormal liver function tests in a 66-year-old female with rheumatoid arthritis, receiving infliximab. Conclusion. Emphasizing histoplasmosis as a major cause of acute granulomatous hepatitis and fever of unknown origin in cell mediated immunodeficient population, this case highlights the need for high index of suspicion and the importance of prompt diagnosis since any delay of treatment can be life threatening in this population.
publisher	Hindawi Publishing Corporation
publishDate	2014
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070324/
_version_	1612105941298184192

Histoplasmosis Presenting as Granulomatous Hepatitis: Case Report and Review of the Literature

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