Pancytopenia and Progressive Splenomegaly in Patient with Disseminated Histoplasmosis

Disseminated histoplasmosis is a severe manifestation of fungal infection caused by Histoplasma capsulatum. It usually occurs in a patient with an immunodeficiency state. With the increase of HIV infection and the use of immunosuppressant drugs lately, its prevalence also increases. A case of 43 years old female with prolonged fever, pancytopenia, and massive progressive splenomegaly. The diagnosis of disseminated histoplasmosis and the secondary hemophagocytic syndrome was made based on bone marrow examination that showed increased hemophagocytic processes and multiple intracytoplasmic H.capsulatum. She had been treated with Itraconazole 200 mg for three months. In the first month's evaluation, her complete blood count improved without any transfusions, and the size of her spleen size decreased. She had been fully recovered after the completion of 3-month treatment.