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Disseminated histoplasmosis presenting as haemolytic anaemia
  1. Yao-Tien Chang1,2,3,4,
  2. Shih-Che Huang1,2,3,
  3. Sung-Yuan Hu1,2,3,4,
  4. Yu-Tse Tsan1,2,3,
  5. Lee-Min Wang1,2,3,5,
  6. Ren-Ching Wang6
  1. 1Department of Emergency Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China
  2. 2Department of Emergency Medicine, Chung Shan Medical University Hospital, Taiwan, Republic of China
  3. 3School of Medicine, Chung Shan Medical University, Taiwan, Republic of China
  4. 4National Taichung Nursing College, Taiwan, Republic of China
  5. 5School of Medicine, National Yang-Ming University, Taiwan, Republic of China
  6. 6Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China
  1. Correspondence to Dr Sung-Yuan Hu, Department of Emergency Medicine, Taichung Veterans General Hospital, No 160, Sec 3, Chung-Kang Road, Taichung 00407, Taiwan, Republic of China; song9168{at}pie.com.tw

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Brief history

A 65-year-old woman, a hepatitis C virus carrier with a history of gallstones for which she had laparoscopic cholecystectomy in August 2007 (when complete blood cell counts and chest x-ray were normal) started taking prednisolone 10 mg per day for haemolytic anaemia in March 2008 (when a chest x-ray revealed an infiltrative lesion over the right middle lung). She was admitted to our institution in September 2008 for a cough with scanty sputum, night sweating and leg oedema for 1 month and a body weight loss of 6 kg over the preceding 6 months. Physical examination showed a pale appearance with mild icteric sclera and no hepatosplenomegaly. Laboratory evaluation revealed: a white blood cell count of 4000/mm3 with 84.1% neutrophils; haemoglobin 8.8 g/dl; platelet count of 42×103/mm3; C-reactive protein 4.2 mg/dl; …

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