PMC10115450_01
Photograph of a critically ill patient with disseminated
histoplasmosis and advanced HIV showing papules on the face secondary to
the fungal disease (A); chest computed tomography showing some small,
peripheral and regular non-calcified nodules in the anterior segment of
the upper right lobe and in the superior lingular segment (B);
Giemsa-stained peripheral blood smear showing yeast-like bodies inside
macrophages with morphology suggestive of Histoplasma
spp. (C); numerous small yeast (2-4 microns in size) with
narrow based grouped in clusters inside macrophages (Grocott methenamine
silver-stained, 1000X) (D).
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PMC10115450_01_1678-9946-rimtsp-65-S1678-9946202365028-gf01.jpg
f01
The lung sounds were clear upon auscultation, the abdomen was innocent, and there was no peripheral lymphadenopathy, but diffuse maculopapular and crusty skin lesions were noticed (Figure 1A). The chest computed tomography (CT) showed unspecific findings (Figure 1B). Yeasts suggestive of Histoplasma spp. were observed in the cytoplasm of macrophages of a routine peripheral blood smear (Figure 1C). Histoplasma spp. also were observed in the cytoplasm of macrophages in the bone marrow and skin samples (Figure 1D) on days 3 and 7, respectively. Hemophagocytosis was not observed in the bone marrow.