Disseminated Histoplasmosis Presenting as Skin Nodules

Aim: We present a case of histoplasmosis presenting with skin nodules and lymphadenopathy from a non endemic area.

Case Presentation: A 60-year-old male presented with multiple skin nodules and lymphadenopathy.

Discussion: Histoplasmosis is a rare fungal infection caused by dimorphic fungus Histoplasma capsulatum, occurring in AIDS patients and other immunocompromised individuals. It usually causes pulmonary infection, following which dissemination to the other parts of the body can occur through lymphatics and bloodstream. Skin lesions mimicking tuberculosis or malignancy can be presenting feature of disseminated histoplasmosis in 10% of patients. Histoplasmosis is endemic in Central and South America and Africa. In India it is endemic in east Indian states.

Conclusion: Due to non specific clinical presentations, low clinical suspicion especially from non endemic areas and lack of proper diagnostic facilities, a diagnosis of histoplasmosis is not sought. Delay in diagnosis often leads to delayed treatment increasing morbidity and mortality.