A Rare Case of Chronic Progressive Disseminated Histoplasmosis in South Western Nigeria

Abstract

Histoplasmosis is a fungal infection that is endemic in Sub-Saharan Africa and some parts of America. The chronic disseminated form of this disease is
uncommon, and usually manifest in individuals with immunosuppression. However, it can mimic a host of other chronic clinical conditions such as
tuberculosis, sarcoidosis, lymphoma and toxoplasmosis, thus resulting in diagnostic challenges. We report a case of a 37 year old male from South-West
Nigeria who was initially treated as a case of miliary tuberculosis without improvement. He gave a past history of travelling to an endemic region for
Histoplasmosis, where he worked in a missionary ï€eld in Kaduna, North-West Nigeria prior to presentation. He had multiple pulmonary miliary and
cavitatory lesions, with multiple cerebral and cerebellar enhancing ring lesions. However, he tested negative for human immunodeï€ciency virus (HIV), but
had a background immunodeï€ciency, as evidenced by his low CD4 count < 300cells/mm3. He was ï€nally diagnosed as a case of chronic progressive
disseminated histoplasmosis through exhaustive laboratory and radiological investigations with remarkable response to treatment.