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Órgano Oficial de la Sociedad
Latinoamericana de lnfectología Pediátrica.
Órgano de la Asociación Mexicana de
Infectología Pediátrica, A.C.
Órgano difusor de la Sociedad Española
de lnfectología

2025, Number 4

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Rev Latin Infect Pediatr 2025; 38 (4)

Hepatic histoplasmosis without pulmonary involvement in an immunocompetent pediatric patient. A case report

Loor VED, Vilcacundo PDG, Proaño DLCHJ

Language: Spanish
References: 6
Page: 162-167
PDF size: 767.38 Kb.


ABSTRACT

Histoplasmosis is a type of mycosis caused by Histoplasma capsulatum, a dysmorphic fungus endemic to areas with nitrogen-rich soils, primarily due to contamination with bird and bat feces. The main risk factor is a deficient immune response; these patients are susceptible to invasive infections, such as the disseminated form. However, those with a favorable immune response are not excluded. This case report is based on a three-year-old male preschooler, without malnutrition, who presented with fever, abdominal pain and distension, and weight loss. Physical examination revealed hepatomegaly and lymphadenopathy; based on the clinical presentation, histoplasmosis was suspected. The diagnosis was made via liver biopsy, which revealed the presence of intracellular yeast consistent with H. capsulatum and a positive immunodiffusion test. Amphotericin B deoxycholate was initiated for 28 days, but fever spikes persisted, ranging from 38 to 40°C. On day 29, oral itraconazole was started, and the fever subsided after 35 days. Despite multiple systemic complications, the patient is recovering successfully and is receiving oral itraconazole treatment according to the international regimen.


REFERENCES

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  2. Mittal J, Ponce MG, Gendlina I, Nosanchuk JD. Histoplasma capsulatum: mechanisms for pathogenesis. In: Rodrigues ML, editor. Fungal physiology and immunopathogenesis [Internet]. Cham: Springer International Publishing; 2018, pp. 157-191. (Current Topics in Microbiology and Immunology; vol. 422). Available in: http://link.springer.com/10.1007/82_2018_114

  3. Sayeed M, Benzamin M, Nahar L, Rana M, Aishy AS. Hepatic histoplasmosis: an update. J Clin Transl Hepatol. 2022; 10 (4): 726-729.

  4. MacInnes R, Warris A. Paediatric histoplasmosis 2000-2019: a review of 83 cases. J Fungi (Basel). 2021; 7 (6): 448.

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