Case Report: Hemophagocytic Lymphohistiocytosis Caused by Disseminated Histoplasmosis in a Venezuelan Patient with HIV and Epstein-Barr Virus Reactivation Who Traveled to Japan.

Publisher: American Society of Tropical Medicine and Hygiene Country of Publication: United States NLM ID: 0370507 Publication Model: Print Cited Medium: Internet ISSN: 1476-1645 (Electronic) Linking ISSN: 00029637 NLM ISO Abbreviation: Am J Trop Med Hyg Subsets: MEDLINE

Publication: Northbrook, IL : American Society of Tropical Medicine and Hygiene
Original Publication: Baltimore.

Epstein-Barr Virus Infections/*diagnosis ; HIV Infections/*diagnosis ; Histoplasmosis/*diagnosis ; Lymphohistiocytosis, Hemophagocytic/*diagnosis; Amphotericin B/therapeutic use ; Antiviral Agents/therapeutic use ; Epstein-Barr Virus Infections/complications ; Epstein-Barr Virus Infections/drug therapy ; Epstein-Barr Virus Infections/virology ; Female ; HIV/drug effects ; HIV/pathogenicity ; HIV/physiology ; HIV Infections/complications ; HIV Infections/drug therapy ; HIV Infections/virology ; Herpesvirus 4, Human/drug effects ; Herpesvirus 4, Human/pathogenicity ; Herpesvirus 4, Human/physiology ; Histoplasma/drug effects ; Histoplasma/pathogenicity ; Histoplasma/physiology ; Histoplasmosis/complications ; Histoplasmosis/drug therapy ; Histoplasmosis/virology ; Humans ; Japan ; Lymphohistiocytosis, Hemophagocytic/complications ; Lymphohistiocytosis, Hemophagocytic/drug therapy ; Lymphohistiocytosis, Hemophagocytic/virology ; Middle Aged ; Travel ; Venezuela

We describe a Venezuelan visitor to Japan who was diagnosed with hemophagocytic lymphohistiocytosis (HLH). The patient was also diagnosed with human immunodeficiency virus (HIV) and Epstein-Barr virus infection by the Western blot and polymerase chain reaction (PCR) tests, respectively. The cause of HLH was considered to be these two infections at first; however, the patient did not recover with antiretroviral/anti-herpes virus therapy. Thereafter, diagnosis of disseminated histoplasmosis was confirmed with an antigen detection test, culture, and PCR test of blood, urine, and bone marrow, and the patient improved gradually after the initiation of liposomal amphotericin B. This case highlights the importance of ruling out endemic mycosis as a cause of HLH even if other probable causes exist in patients from endemic areas.

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0 (Antiviral Agents)
0 (liposomal amphotericin B)
7XU7A7DROE (Amphotericin B)

Date Created: 20190118 Date Completed: 20191211 Latest Revision: 20200309

20231215

PMC6367636

10.4269/ajtmh.18-0478

30652668