PMC9245433_01
Abdominal CT scan showed splenomegaly and hepatomegaly (black arrows).
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Computed tomography (CT) of the chest was normal but the abdominal CT showed hepatosplenomegaly and posterior peritoneum lymphadenopathy ( Figure 1 ).
HE stain of bone marrow puncture images (x1,000). These oval or round organisms with amaranth nuclei and capsule-like unstained halos around observed in the cytoplasm of phagocytes (yellow arrow).
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Hematoxylin and eosin (HE)-stained bone marrow demonstrated oval or round organisms with amaranth nuclei and capsule-like unstained halos around these organisms observed in the cytoplasm of phagocytes ( Figure 2 ).
(A) The colonies of Histoplasma capsulatum on Columbia blood agar medium after subculture, the fungus is milky white with villous hyphae in the outer ring. (B) Cogwheel-like macroconidia of Histoplasma capsulatum stained with Lactophenol cotton blue after subculture, x400 magnification. (C) Hyphae and spores are bright blue fluorescent in Fluorescence staining, 100x magnification. (D) Lactophenol cotton blue staining in primary culture with cogwheel-like macroconidia, x400 magnification.
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These are shown in  Figure 3 , which finally confirmed as Histoplasma capsulatum.