Disseminated histoplasmosis in a patient with NADPH oxidase deficiency: a case report

Neutrophil nicotinamide adenine dinucleotide phosphate (NADPH) Oxidase plays a pivotal role in the production of reactive oxygen species and defect of its different subunit leads to the development of chronic granulomatous diseases. The defect of different sub-units of neutrophil NADPH oxidase affects different organs1.In endemic region, histoplasmosis is often seen in host with defective cell mediated immunity. Host with primary immunodeficiency with disseminated histoplasmosis is rare. Host with primary immunodeficiency due to Neutrophil NADPH Oxidase is even rarer2.One such presentation was seen in a 49 years old man who presented to us with recurrent attacks of histoplasmosis involving different organs which was treatment refractory. We report this case so that physicians can consider correlation between primary immunodeficiency and treatment refractory disseminated histoplasmosis in a seemingly immunocompetent patient.