Disseminated Histoplasmosis as an AIDS-Defining Illness Presenting as Fever of Unknown Origin in an 11-Year-Old Female
A previously healthy 11-year-old female, who emigrated from Central America four years prior, was admitted with eight days of fever, night sweats, and anorexia. Past medical history included severe bronchiolitis, varicella, and hepatitis A as a child. Upon admission, her physical exam was significan...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2019/9417102 |
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| _version_ | 1832563048174321664 |
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| author | Kathryn E. Kalata Christina Osborne Amy Willis Kacey Navarro Laura Z. Fenton Christiana Smith |
| author_facet | Kathryn E. Kalata Christina Osborne Amy Willis Kacey Navarro Laura Z. Fenton Christiana Smith |
| author_sort | Kathryn E. Kalata |
| collection | DOAJ |
| description | A previously healthy 11-year-old female, who emigrated from Central America four years prior, was admitted with eight days of fever, night sweats, and anorexia. Past medical history included severe bronchiolitis, varicella, and hepatitis A as a child. Upon admission, her physical exam was significant for nontender cervical lymphadenopathy, intermittent erythematous papules on the upper extremities, and mild abdominal tenderness. Initial laboratory studies revealed leukopenia, anemia, elevated inflammatory markers, and antibodies to HIV-1 in the patient’s serum and cerebrospinal fluid. Computed tomography scan was remarkable for many small nodules throughout the lungs and widespread lymphadenopathy. Additional testing confirmed the diagnosis of HIV/AIDS with a CD4 count of 52 cells/mm3, complicated by disseminated histoplasmosis. This case is significant because it represents a late presentation of vertically transmitted HIV with disseminated histoplasmosis in a nonendemic region as the AIDS-defining illness. This highlights the importance of maintaining a broad differential for opportunistic infections, especially among those who have spent a significant amount of time in a country where unusual pathogens may be more common. This case also considers the utility of antigen testing as a sensitive diagnostic test in immunocompromised patients. |
| format | Article |
| id | doaj-art-ba38268b196f4b51a206b431de4ceb33 |
| institution | Kabale University |
| issn | 2090-6803 2090-6811 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-ba38268b196f4b51a206b431de4ceb332025-02-03T01:21:14ZengWileyCase Reports in Pediatrics2090-68032090-68112019-01-01201910.1155/2019/94171029417102Disseminated Histoplasmosis as an AIDS-Defining Illness Presenting as Fever of Unknown Origin in an 11-Year-Old FemaleKathryn E. Kalata0Christina Osborne1Amy Willis2Kacey Navarro3Laura Z. Fenton4Christiana Smith5University of Colorado School of Medicine, 13001 E. 17th Place, Aurora, CO 80045, USAPediatric Infectious Diseases, University of Colorado School of Medicine, 13123 East 16th Avenue, Box 055, Aurora, CO 80045, USAPediatric Hospital Medicine, University of Colorado School of Medicine, 13123 East 16th Avenue, Box 302, Aurora, CO 80045, USAPediatric Infectious Diseases, Children's Hospital Colorado, 13123 East 16th Avenue, Box 055, Aurora, CO 80045, USAPediatric Radiology, University of Colorado School of Medicine, 13123 East 16th Avenue, Box 125, Aurora, CO 80045, USAPediatric Infectious Diseases, University of Colorado School of Medicine, 13123 East 16th Avenue, Box 055, Aurora, CO 80045, USAA previously healthy 11-year-old female, who emigrated from Central America four years prior, was admitted with eight days of fever, night sweats, and anorexia. Past medical history included severe bronchiolitis, varicella, and hepatitis A as a child. Upon admission, her physical exam was significant for nontender cervical lymphadenopathy, intermittent erythematous papules on the upper extremities, and mild abdominal tenderness. Initial laboratory studies revealed leukopenia, anemia, elevated inflammatory markers, and antibodies to HIV-1 in the patient’s serum and cerebrospinal fluid. Computed tomography scan was remarkable for many small nodules throughout the lungs and widespread lymphadenopathy. Additional testing confirmed the diagnosis of HIV/AIDS with a CD4 count of 52 cells/mm3, complicated by disseminated histoplasmosis. This case is significant because it represents a late presentation of vertically transmitted HIV with disseminated histoplasmosis in a nonendemic region as the AIDS-defining illness. This highlights the importance of maintaining a broad differential for opportunistic infections, especially among those who have spent a significant amount of time in a country where unusual pathogens may be more common. This case also considers the utility of antigen testing as a sensitive diagnostic test in immunocompromised patients.http://dx.doi.org/10.1155/2019/9417102 |
| spellingShingle | Kathryn E. Kalata Christina Osborne Amy Willis Kacey Navarro Laura Z. Fenton Christiana Smith Disseminated Histoplasmosis as an AIDS-Defining Illness Presenting as Fever of Unknown Origin in an 11-Year-Old Female Case Reports in Pediatrics |
| title | Disseminated Histoplasmosis as an AIDS-Defining Illness Presenting as Fever of Unknown Origin in an 11-Year-Old Female |
| title_full | Disseminated Histoplasmosis as an AIDS-Defining Illness Presenting as Fever of Unknown Origin in an 11-Year-Old Female |
| title_fullStr | Disseminated Histoplasmosis as an AIDS-Defining Illness Presenting as Fever of Unknown Origin in an 11-Year-Old Female |
| title_full_unstemmed | Disseminated Histoplasmosis as an AIDS-Defining Illness Presenting as Fever of Unknown Origin in an 11-Year-Old Female |
| title_short | Disseminated Histoplasmosis as an AIDS-Defining Illness Presenting as Fever of Unknown Origin in an 11-Year-Old Female |
| title_sort | disseminated histoplasmosis as an aids defining illness presenting as fever of unknown origin in an 11 year old female |
| url | http://dx.doi.org/10.1155/2019/9417102 |
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