Diagnostic Value of Skin Biopsy in Fatal Histoplasmosis-Associated Hemophagocytic Lymphohistiocytosis: A Case Report - Takeaways - MDSpire
Coming Soon: Introducing MDSpire News. Learn more
Conexiant’s news site is now MDSpire News. Learn more

Skin Biopsy as a Diagnostic Tool in Fatal Histoplasmosis-Associated Hemophagocytic Lymphohistiocytosis: A Case Report

  • By

  • Jaclyn Roland-McGowan

  • Riyad N. H. Seervai

  • Claudia Lee

  • Stephanie Mengden Koon

  • Jesse J. Keller

  • October 13, 2026

Share

  • 1

    A 41-year-old man receiving adalimumab developed fatal disseminated histoplasmosis-associated hemophagocytic lymphohistiocytosis (HLH).

  • 2

    Despite negative bone marrow fungal stains, a skin biopsy of subtle acneiform papules showed numerous invasive organisms.

  • 3

    Fungal PCR with reflex next-generation sequencing of the skin specimen identified Histoplasma capsulatum 28S ribosomal DNA.

  • 4

    Urine Histoplasma antigen was positive, while extensive testing had not identified another infectious or malignant HLH trigger.

  • 5

    The case authors note that TNF-α inhibitor exposure should raise concern for invasive fungal infection during HLH evaluation.

Original Source(s)

Diagnostic Value of Skin Biopsy in Fatal Histoplasmosis-Associated Hemophagocytic Lymphohistiocytosis: A Case Report

  • by Jaclyn Roland-McGowan, Riyad N. H. Seervai, Claudia Lee, Stephanie Mengden Koon, Jesse J. Keller

  • October 13, 2026

Related Content

RE: Putting the PASC Score to the Test: Clinical vs. Statistical Accuracy in Long COVID Diagnosis (Azola et al. JGIM)

Clinical trials testing early multimodal vasopressor therapy require a dose ceiling, not a dose floor

Pleonasms in infectious diseases: more than just a superfluous misnomer?