PMC6360956_01
Ill-defined, painful, erythematous and edematous plaques on the left thigh
and leg
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f1
Subsequently, the dermatosis progressed, and she developed haemophagocytic syndrome (Figure 1).
Skin biopsy. PAS staining showing oval yeasts (2-to 4microm), some with
narrow-based budding (x100)
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f2
A third skin biopsy revealed septal and lobular panniculitis with oval and narrow-based budding yeasts observed with the PAS staining (Figure 2).
A - Sabouraud dextrose agar culture at 25 C showing white,
cotton-like colonies of Histoplasma capsulatum. B - Hyaline and
septate hyphae with abundant tuberculate, thick-walled macroconidia
(Lactophenol cotton blue stain x40)
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f3
White mold colonies grew in the Sabouraud agar media from the skin and bone marrow samples; the direct examination with cotton-blue staining showed septate, hyaline hyphae, and tuberculate macroconidia compatible with Histoplasma capsulatum (Figure 3).