• Qingxia Ling, Weishan Zhu, Qun Lu, Ting Jin, and Shenhua Ding.
• Department of Infectious Diseases, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China.
• Medicine (Baltimore). 2018 Jul 1; 97 (29): e11486.

RationaleDisseminated histoplasmosis is a rare fungal infection and most documented cases are in immunocompromised individuals such as those with acquired immunodeficiency syndrome. However, histoplasmosis easily goes unrecognized in immunocompetent populations.Patient ConcernsWe report a rare case of histoplasmosis that was manifested as persistent fever and abnormal liver function in a 45-year-old immunocompetent female from Jiangsu Province.DiagnosesInvestigations revealed anemia and thrombocytopenia. Giemsa-stained bone marrow aspirate showed yeast-like cells, suggestive of Histoplasma capsulatum. Wright-stained bone marrow aspirate confirmed the diagnosis.InterventionsThe patient was treated by amphotericin B (amphotericin B liposome) and itraconazole.OutcomesOur patient responded well to the treatment.LessonsEmphasizing histoplasmosis as a cause of fever of unknown origin in an immunocompetent patient, this case highlights the need for an index of suspicion and the importance of prompt diagnosis, as any delay of treatment can be life threatening.

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