Author/Authors :
Krishnamurthy, Premmapassan Department of Medicine - Dr. Ram Manohar Lohia Hospital, New Delhi, India , Sharma, Brijesh Department of Medicine - Dr. Ram Manohar Lohia Hospital, New Delhi, India , Deepak, Desh Department of Medicine - Dr. Ram Manohar Lohia Hospital, New Delhi, India , Shukla, Shailaja Department of Pathology - Lady Hardinge Medical College & Smt. S. K. Hospital, New Delhi, India , Arya, Vishakha Department of Pathology - Lady Hardinge Medical College & Smt. S. K. Hospital, New Delhi, India , Chowdhary, Anuradha Department of Mycology - Vallabhbhai Patel Chest Institute - University of Delhi, New Delhi, India
Abstract :
We report a case of a 40-year-old male patient who developed a fever one week after recovering from
severe COVID-19 illness that had needed treatment with injectable corticosteroids and Tocilizumab.
The patient had had maculopapular lesions on his trunk months before contracting COVID-19, but the
skin lesions progressed along with the post-covid fever. Detailed workup and biopsy from skin lesions
on the face, trunk, and bone marrow revealed Histoplasmosis. This case highlights the possibility of
flaring up of Histoplasmosis in COVID-19 patients who have been treated with immunosuppressants.
In our case, the plausible reason for reactivation and growth of Histoplasma may be the suppression
of IL6 action by Tocilizumab.
It may be prudent to screen patients for Histoplasma and other fungal infections like aspergillus
before administering an immune-suppressive regimen in patients with a moderate or severe COVID-
19 illness. Urinary Histoplasma antigen may be used for screening in these patients. J Microbiol Infect
Dis 2021; 11(3):170-173.
