Disseminated histoplasmosis in an AIDS patient with immunologic non-response to HAART: A case report

Histoplasmosis in Africa is caused by Histoplasma capsulatum var duboisii (Hcd) and/or Histoplasma capsulatum var capsulatum (Hcc)[1]. It occurs predominantly in immunocompetent patients as localized disease and less commonly in HIV positive patients as disseminated disease [2]. The most significant risk factor for histoplasmosis in Africa is HIV [3]. Histoplasmosis is often mis-diagnosed and treated empirically as tuberculosis (TB) in HIV patients in TB endemic areas [2,3]. The advent of highly active antiretroviral therapy (HAART) has not been associated with a significant decline in the incidence of histoplasmosis globally thus underscoring the importance of diagnosing this treatable condition in endemic regions [4]. We report a case of disseminated histoplasmosis in an AIDS patient with good clinical response to antifungal therapy but failure of immune reconstititution with HAART.