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Revista Cubana de Medicina Militar
On-line version ISSN 1561-3046
Abstract
SERNA, Isasio et al. Histoplasmosis and SARS-CoV-2 infection in a critically ill patient. Rev. cuban. med. mil. [online]. 2023, vol.52, n.1 Epub Mar 01, 2023. ISSN 1561-3046.
Introduction:
Histoplasmosis is caused by the dimorphic fungus Histoplasma capsulatum, whose clinical manifestations range from asymptomatic to disseminated and highly fatal disease.
Objective:
To present the case of a patient diagnosed with disseminated histoplasmosis and SARS-CoV-2 infection.
Clinical case:
The case of a 79-year-old man is presented with a history of systemic arterial hypertension and type 2 diabetes mellitus. He was admitted for a week with nonproductive cough, dyspnea, and fatigue on moderate exertion, and reported having a positive antigen test for SARS- CoV-2. During hospitalization, he presented clinical deterioration, needing mechanical ventilation due to respiratory infection associated with COVID-19. Despite this, he presented lymphadenopathy, hepatosplenomegaly, and umbilicated skin-colored papules suggestive of disseminated fungal infection. Suspecting co-infection, infection by Histoplasma capsulatum was confirmed by means of mini-bronchoalveolar lavage and antifungal treatment was initiated; however, the patient presented persistent clinical deterioration and died.
Conclusion:
Cases of co-infections with COVID-19 in patients without chronic diseases or immunosuppressive states are rare, their diagnosis being a challenge for medical personnel and requiring consideration of pulmonary fungal infections such as cryptococcosis or histoplasmosis in associated respiratory failure. to SARS-CoV-2 infection.
Keywords : COVID-19; SARS-CoV-2; histoplasmosis; immunocompetent.