PMC9427377_01
Histology from a cervical nodule - remark the presence of numerous uninucleate thick-walled large yeasts Histoplasma capsulatum var. duboisii (Hcd) along with numerous histiocytes (HE - 400x). Below a Grocott stain displays the thick wall of the yeasts as well as the budding (600x).
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Meanwhile, a cervical nodular biopsy revealed necrotic areas along with others containing numerous histiocytes with multinucleated giant cells, polymorphic inflammatory infiltrate, and numerous uninucleate thick-walled large yeasts, budding from a narrow base (Fig. 1, arrow).
Abdominal computerized tomography showing multiple retroperitoneal lymphadenopathies.
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A painful supra-pubic abdominal mass appeared, and abdominal CT identified numerous new retroperitoneal lymphadenopathies and left hydronephrosis due to direct compression of the ureter (Fig. 2).
Cervical nodular formations at days 4 (A) and 22 (B) of posaconazole therapy, along with cervical (C) and inguinal (D) regions after complete cicatrization.
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A dramatic and lasting improvement, both clinical (Fig. 3A-D) and biochemical, was observed. At day 127 of posaconazole therapy, complete cicatrization of all skin lesions was achieved (Fig. 3).