Woman in Guangxi diagnosed with rare histoplasmosis case

A 57-year-old woman in Guangxi, China, has been diagnosed with disseminated histoplasmosis. This rare fungal infection is caused by the H. capsulatum fungus and typically affects individuals with weakened immune systems. The patient showed symptoms such as growing skin nodules on her neck and upper chest, breathing difficulties, and low back pain. Despite initial antibiotic treatment at a local hospital, her condition worsened. She had no known exposure to the typical sources of H. capsulatum, like bird or bat droppings, making this case particularly unusual. Upon examination, doctors found several large, tender nodules on her skin and an enlarged lymph node in her armpit. Imaging tests revealed a significant mass in her chest and signs of bone damage. Laboratory tests showed anemia and increased white blood cells, but she tested negative for HIV. A sample taken from her skin lesions revealed the presence of H. capsulatum through specialized genetic testing, confirming the diagnosis of disseminated histoplasmosis. The patient started treatment with amphotericin B, followed by itraconazole, and showed some improvement. Doctors also tested her for anti-IFN-γ autoantibodies, which can indicate a rare immunodeficiency. The test came back positive, suggesting her immune system was compromised, further increasing her risk for infections like histoplasmosis. Histoplasmosis is rare in Guangxi but may be linked to the region's warm and humid climate, which can support the growth of this fungus. The symptoms are often similar to other infections common in the area, making diagnosis challenging. This case highlights the need for awareness of immunodeficiencies and the value of advanced testing methods like metagenomic next-generation sequencing in diagnosing rare infections quickly. Ongoing follow-up for the patient will be crucial to monitor her recovery and immune status.