Case Report

Volume: 8 | Issue: 6 | Published: Jun 08, 2024 | Pages: 126 - 129 | DOI: 10.24911/ejmcr.173-1712472676

Hemophagocytosis with disseminated histoplasmosis detected through bone marrow analysis – a case report


Authors: Hari Priya Raghvan , Ehram Jamian , Caroline Ho , Wee Shiang Yiu , Dayangku Seritul Akmar Abd Razak , Nur Afiza Aziz , Indhira Subbiah


Article Info

Authors

Hari Priya Raghvan

Hematology Unit, Pathology Department, Hospital Sultanah Aminah, Johor Bahru, Ministry of Health, Malaysia

Ehram Jamian

Hematology Unit, Pathology Department, Hospital Sultanah Aminah, Johor Bahru, Ministry of Health, Malaysia

Caroline Ho

Hematology Unit, Pathology Department, Hospital Sultanah Aminah, Johor Bahru, Ministry of Health, Malaysia

Wee Shiang Yiu

Hematology Unit, Pathology Department, Hospital Sultanah Aminah, Johor Bahru, Ministry of Health, Malaysia

Dayangku Seritul Akmar Abd Razak

Microbiology Unit, Pathology Department, Hospital Sultanah Aminah, Johor Bahru, Ministry of Health, Malaysia

Nur Afiza Aziz

Microbiology Unit, Pathology Department, Hospital Sultanah Aminah, Johor Bahru, Ministry of Health, Malaysia

Indhira Subbiah

Hematology Unit, Pathology Department, Hospital Sultanah Aminah, Johor Bahru, Ministry of Health, Malaysia.

Publication History

Received: April 08, 2024

Revised: April 29, 2024

Accepted: April 29, 2024

Published: June 08, 2024


Abstract


Background: Histoplasmosis is caused by Histoplasma capsulatum which can lead to a broad spectrum of disease. Culture remains the gold standard till date; however, this is a slow-growing fungus that may take a considerable time before a conclusion can be made. This case highlights the importance of careful bone marrow evaluation to identify the fungal bodies, especially in the presence of increased hemophagocytic activity. Case Presentation: We present a 36-year-old man with newly diagnosed retroviral disease, presented with fever, pancytopenia, and hepatosplenomegaly. Bone marrow aspirate smear showed increased hemophagocytic activity with the presence of intracellular organisms. Trephine biopsy showed similar features with the presence of fungal bodies detected via Periodic acidSchiff stain. Conclusion: In conclusion, bone marrow examination plays a crucial role in the diagnosis of some fungal infections, especially in centers where culture or serological tests are not readily available.

Keywords: Histoplasma capsulatum, Histoplasmosis, HLH, hemophagocytosis, pancytopenia, case report, green