Histoplasmosis in an immunocompetent adult

Histoplasmosis is a fungal infection of the skin and lungs, often involving multiple organs. They are opportunistic mycoses usually in HIV-positive patients. Herein, we report the case of a 51-year-old immunocompetent adult. On examination, the patient was generally unwell and had no fever. Multiple subcutaneous nodules were noted. These nodules were of variable size, ulcerated in places, umbilicated in appearance, and painful to the touch. They were located on the head, nose, back, thighs, and arms. Bilateral symmetrical axillary lymph nodes were firm, painless, and mobile. Tzanck cytodiagnosis showed birefringent cells in all fields. A chest X-ray showed accentuated vascular patterns and basal pleurisy. Skin and lymph node biopsies were consistent with Histoplasma capsulatum duboisii histoplasmosis. The patient was treated with itraconazole. After eight months of treatment, we noted complete healing of the lesions. Key words: Cutaneous histoplasmosis, Immunocompetent, Disseminated