Disseminated histoplasmosis mimicking miliary tuberculosis: a case report
Chan, K.S.; Looi, L.M.; Chan, S.P.
Malaysian Journal of Pathology 15(2): 155-158
1993
ISSN/ISBN: 0126-8635 PMID: 8065179 Document Number: 405192
A case is reported in a 35-yr-old diabetic man in Malaysia who presented with a 1-month history of fever and weight loss. Chest radiography demonstrated numerous tiny miliary shadows and tuberculosis was suspected. Before a diagnosis was established the patient fell to his death from his ward on the 12th floor. Post-mortem examination of the lungs revealed numerous, confluent yellowish white caseous nodules approx. 2 mm in diam. and the adrenal glands contained nodular, yellowish lesions. Yeast cells that stained with Gomori methenamine silver, typical of Histoplasma capsulatum, were observed in necrotic tissue of the adrenal glands and lungs. Lesions and yeast cells were also present in the kidneys, thyroid and spleen and the liver contained tiny numerous lesions. Disseminated histoplasmosis was diagnosed.