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- Bone marrow biopsy
- disseminated histoplasmosis
- haemolytic anaemia
- histoplasma capsulatum
- diagnostic microbiology
- adult intensive & critical care
- respiratory infections
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; …
Competing interests None.
Patient consent Obtained from patient's next of kin.
Provenance and peer review Not commissioned; externally peer reviewed.
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