DISSEMINATED HISTOPLASMOSIS SUCCESSFULLY TREATED WITH LIPOSOMAL AMPHOTERICIN-B FOLLOWING AZATHIOPRINE THERAPY IN A PATIENT FROM A NONENDEMIC AREA

Histoplasma infections in Europe are rare, and acute disseminated hist oplasmosis has been observed only in immunocompromised persons. An unu sual case of autochthonous disseminated histoplasmosis ina 22-year-old Spanish man who had been treated with azathioprine and prednisone for 4 weeks before admission is reported. The development of an acute for m of the disease may represent an endogenous reactivation of a latent infection as a complication of immunosuppression resulting from the us e of these drugs. This case illustrates the potential risk of this opp ortunistic fungal infection in patients receiving azathioprine therapy , an association that has been rarely described before.