TY - JOUR A2 - Bahloul, Mabrouk AU - Kashif, Muhammad AU - Tariq, Hassan AU - Ijaz, Mohsin AU - Gomez-Marquez, Jose PY - 2015 DA - 2015/08/10 TI - Disseminated Histoplasmosis and Secondary Hemophagocytic Syndrome in a Non-HIV Patient SP - 295735 VL - 2015 AB - Histoplasma duboisii, a variant of Histoplasma capsulatum that causes “African histoplasmosis,” can be resistant to itraconazole, requiring intravenous amphotericin B treatment. Rarely, these patients do not respond to intravenous antifungal therapy, and in such cases, patients may progress to develop secondary hemophagocytic lymphohistiocytosis (HLH). We present a case of a 34-year-old male patient with sickle cell disease who presented with a 5-month history of an enlarging painless axillary mass, persistent low grade fevers, night sweats, weight loss, and anorexia. An excisional biopsy of the right axillary lymph node revealed yeast and granulomas consistent with histoplasma infection. He was started on oral itraconazole. After 4 weeks of therapy, laboratory evaluation revealed worsening anemia, thrombocytopenia, and transaminitis. Due to failure of oral therapy, he was admitted for intravenous amphotericin B treatment. During his hospital course anemia, thrombocytopenia, and transaminitis all worsened. A bone marrow biopsy was done that was consistent with HLH. His clinical status continued to deteriorate, developing multiorgan failure and disseminated intravascular coagulation. He unfortunately had a cardiorespiratory arrest after eight days of admission and passed away. SN - 2090-6420 UR - https://doi.org/10.1155/2015/295735 DO - 10.1155/2015/295735 JF - Case Reports in Critical Care PB - Hindawi Publishing Corporation KW - ER -