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Disseminated histoplasmosis in peripheral blood smear
Histoplasmosis diseminada. Examen de sangre periférica
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Examen de sangre periférica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 427 "Ancho" => 755 "Tamanyo" => 44314 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 30-year-old man from Medellín, Colombia, presented with two-month history of multiple erythematous purplish nodules on the skin, fever, weight loss, epistaxis, cough, and dysphonia. He had past medical history of AIDS diagnosed ten years ago, without adherence to antiretroviral therapy. CD4 cell count was 5<span class="elsevierStyleHsp" style=""></span>cells/μl and plasma HIV-1 RNA viral load was 150<span class="elsevierStyleHsp" style=""></span>000<span class="elsevierStyleHsp" style=""></span>copies/ml. Physical examination revealed papulonodular skin lesions (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and large ulcerated oral lesions in the posterior oral cavity, oropharynx, and hard palate and non-tender hepatosplenomegaly. The complete blood count showed hemoglobin level of 8<span class="elsevierStyleHsp" style=""></span>g/dl, absolute neutrophil count of 100<span class="elsevierStyleHsp" style=""></span>cells/μl and platelet count of 36<span class="elsevierStyleHsp" style=""></span>000<span class="elsevierStyleHsp" style=""></span>cells/μl. The ferritin level was 3000<span class="elsevierStyleHsp" style=""></span>ng/ml. A peripheral-blood smear revealed oval 2<span class="elsevierStyleHsp" style=""></span>μm yeast (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Skin biopsies showed granulomatous inflammation with similar structures also compatible with yeast. Cytology from bronchoalveolar lavage and urine antigen confirmed the diagnosis of disseminated histoplasmosis. The etiologic spectrum is broad, however, one of the most frequent infections in this geographic region related with profound pancytopenia, visceromegaly, skin and mucosal lesions is histoplasmosis particularly demonstrated in this case from the blood smear.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1005 "Ancho" => 755 "Tamanyo" => 97328 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 427 "Ancho" => 755 "Tamanyo" => 44314 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00257753/0000015800000003/v1_202202020734/S0025775321003547/v1_202202020734/en/main.assets" "Apartado" => array:4 [ "identificador" => "64289" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes médicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000015800000003/v1_202202020734/S0025775321003547/v1_202202020734/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775321003547?idApp=UINPBA00004N" ]
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