<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0375-0760</journal-id>
<journal-title><![CDATA[Revista Cubana de Medicina Tropical]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Med Trop]]></abbrev-journal-title>
<issn>0375-0760</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0375-07602022000200020</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Esplenomegalia masiva en el curso de reactivación de histoplasmosis diseminada en paciente de sida]]></article-title>
<article-title xml:lang="en"><![CDATA[Massive splenomegaly in the course of disseminated histoplasmosis reactivation in an AIDS patient]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez Fernández]]></surname>
<given-names><![CDATA[Liodelvio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[María Paula Campos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Serrano Soler]]></surname>
<given-names><![CDATA[César Augusto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres Cuevas]]></surname>
<given-names><![CDATA[Boris Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arteaga Hernández]]></surname>
<given-names><![CDATA[Ernesto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Clínico Quirúrgico Hermanos Ameijeiras  ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<volume>74</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0375-07602022000200020&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0375-07602022000200020&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0375-07602022000200020&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La histoplasmosis diseminada es la forma de presentación más frecuente de esta micosis endémica en pacientes de sida. La esplenomegalia consecuente es muy frecuente, pero generalmente no es masiva.  Objetivo:  Describir un caso no frecuente de esplenomegalia masiva por histoplasmosis diseminada en un paciente de sida.  Caso clínico:  Se presenta el caso de un paciente de sida diagnosticado hacía 14 años. Desde entonces cumplió tratamiento antirretroviral en forma irregular. Tuvo un primer evento de esta micosis 10 años atrás. En esa ocasión, tuvo tratamiento antimicótico por 4 meses sin continuar con profilaxis secundaria. Inició con síntomas sugestivos de reactivación de la enfermedad 6 meses después. Se mantuvo sintomático en forma recurrente por todos esos años y acudió en fecha actual en estadio avanzado con linfadenopatías grandes y hepatoesplenomegalia masiva. Se confirmó el diagnóstico mediante biopsia ganglionar y se impuso tratamiento antimicótico, con lo cual los síntomas desaparecieron y hubo una reducción ostensible de los órganos que estaban aumentados de tamaño.  Conclusión:  La esplenomegalia masiva puede presentarse en esta enfermedad. En este caso debe haber sido originada por el largo periodo de reactivación, a su vez determinado por el estado de inmunodepresión oscilante, ya muy avanzado en el momento de su presentación, por la irregularidad del tratamiento antirretroviral y la falta de profilaxis secundaria de la micosis.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Disseminated histoplasmosis is the most frequent form of presentation of this endemic mycosis in AIDS patients. Splenomegaly commonly occurs as a consequence of it, but it is not usually massive.  Objective:  To describe an uncommon case of massive splenomegaly caused by disseminated histoplasmosis in an AIDS patient.  Clinical case:  The case of an AIDS patient diagnosed 14 years ago is presented. Since diagnosis, the patient has been under antiretroviral treatment irregularly. The first event of this mycosis was 10 years ago. In that occasion, antimitotic treatment was prescribed for four months without secondary prophylaxis. Six months later, symptoms suggestive of reactivation of the disease started. The patient remained symptomatic on a recurrent basis over these years, and attended recently to the hospital in an advanced stage of the disease with large lymphadenopathies and massive hepatosplenomegaly. Diagnostic was confirmed by node biopsy, and antimycotic treatment was indicated, resulting in the resolution of the symptoms and an evident reduction of the enlarged organs.  Conclusions:  Massive splenomegaly can be present in this disease. In this case, it should have been originated due to a long reactivation period which was determined by the varying and advanced immunosuppressed state, the irregularity with the antiretroviral treatment, and the lack of secondary prophylaxis for the mycosis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[histoplasmosis]]></kwd>
<kwd lng="es"><![CDATA[VIH/sida]]></kwd>
<kwd lng="es"><![CDATA[hepatoesplenomegalia]]></kwd>
<kwd lng="es"><![CDATA[no adherencia al tratamiento]]></kwd>
<kwd lng="en"><![CDATA[histoplasmosis]]></kwd>
<kwd lng="en"><![CDATA[HIV/AIDS]]></kwd>
<kwd lng="en"><![CDATA[hepatosplenomegaly]]></kwd>
<kwd lng="en"><![CDATA[non-adherence to treatment]]></kwd>
</kwd-group>
</article-meta>
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