MICROBIOLOGIC AND HISTOLOGIC DIAGNOSIS OF HISTOPLASMOSIS IN TAIWAN

Histoplasmosis is one of the most common opportunistic fungal infectio ns in immunocompromised patients in endemic areas. We report the first two microbiologically documented cases of histoplasmosis in Taiwan. T he first patient, with acquired immunodeficiency syndrome and a deplet ed CD4+ lymphocyte count, presented with a history of prolonged fever, papular skin rashes, pancytopenia and elevation of liver enzymes. He was diagnosed and treated initially for systemic toxoplasmosis, but th e microbiologic and pathologic findings of the autopsied specimens dis closed disseminated infection caused by Histoplasma capsulatum. The se cond patient, an elderly man receiving corticosteroids for adrenal ins ufficiency, manifested with laryngeal histoplasmosis and was successfu lly treated with ketoconazole.