PMC6885199_01
Maculopapular cutaneous lesions on the trunk.
CRIID2019-7403878.001.jpg
PMC6885199_01_CRIID2019-7403878.001.jpg
fig1
Maculopapular cutaneous lesions were present on the face, trunk, and limbs (Figure 1); hepatosplenomegaly, lateral cervical lymphadenopathy, and fine crackles on both basal lung fields were also detected.
Bone marrow aspirate (a) and peripheral blood smear microscopy (b) showing yeast-like cells of H. capsulatum with a clear halo around them (Jenner-Giemsa stain; 1000x).
CRIID2019-7403878.002.jpg
PMC6885199_01_CRIID2019-7403878.002.jpg
fig2
The latter (see Figure 2(a)) revealed inclusion bodies inside the cytoplasm monocytes, suggestive of H. capsulatum yeasts. An identical finding was observed from the peripheral blood smear (see Figure 2(b)).
H. capsulatum mycelial phase macroconidia and microconidia (lactophenol cotton blue stain, 400x) from Sabouraud dextrose agar plates incubated at 30 C.
CRIID2019-7403878.003.jpg
PMC6885199_01_CRIID2019-7403878.003.jpg
fig3
In the following days, from both the peripheral vein blood and bone marrow aspirate, cultures on Sabouraud dextrose agar incubated at 30 C and grew H. capsulatum (Figure 3).