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Answer to Case 11






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Acute Disseminated Histoplasmosis

The patient also had positive fungal blood cultures and Histoplasma urine antigen assay. He was treated initially with Amphotericin B Lipid Complex, but was changed to IV Itraconazole when he developed renal failure. He was later switched to long-term oral Itraconazole.

Submitted by Dr. Keith Woeltje and Dr. Nancy Garcia, from the Infectious Disease Service at Medical College of Georgia, Augusta, GA. Images submitted by Robert Kazragis, MD, COL, MC, Infectious Disease Service, Dwight David Eisenhower Army Medical Center, Fort Gordon, GA.





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