Disseminated Histoplasmosis Presenting as Pyrexia of Unknown Origin in a Rheumatoid Arthritis Patient

J Assoc Physicians India. 2024 Aug;72(8):107-108. doi: 10.59556/japi.72.0586.

Abstract

We present a case of a 56-year-old female with rheumatoid arthritis (RA) who has been on methotrexate for 9 years and has been complaining of high-grade fever for the past 1 month with no localizing signs and symptoms. She was thoroughly evaluated before being labeled as pyrexia of unknown origin. Histoplasmosis was suspected after bone marrow aspiration smear examination. The presence of histoplasma antigen in the urine confirmed our diagnosis. Fever responded after 2 weeks of liposomal amphotericin B and patient discharged in stable condition on tablet itraconazole.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B* / therapeutic use
  • Antifungal Agents / therapeutic use
  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / diagnosis
  • Arthritis, Rheumatoid* / drug therapy
  • Female
  • Fever of Unknown Origin* / diagnosis
  • Fever of Unknown Origin* / etiology
  • Histoplasma / isolation & purification
  • Histoplasmosis* / complications
  • Histoplasmosis* / diagnosis
  • Histoplasmosis* / drug therapy
  • Humans
  • Itraconazole / therapeutic use
  • Middle Aged

Substances

  • Amphotericin B
  • Antifungal Agents
  • liposomal amphotericin B
  • Itraconazole