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