Clinical Rheumatology

, Volume 26, Issue 10, pp 1717–1719 | Cite as

Unusual manifestation of histoplasmosis in connective tissue diseases

  • F. Ceccato
  • V. Gongora
  • A. Zunino
  • S. Roverano
  • S. PairaEmail author
Brief Report


This report describes the coexistence of three patients with rheumatic diseases (systemic lupus erythematosus, rheumatoid arthritis, and dermatomyositis) and infections because of Histoplasma capsulatum. Connective tissue diseases and histoplasmosis share several clinical findings. Therefore, histoplasmosis could be misdiagnosed as connective tissue disease or a flare of these diseases. Such cases highlight the importance of awareness of histoplasmosis in immunocompromised patients, particularly in those originating from endemic areas.


Connective tissue diseases Histoplasmosis Nasal perforation Panniculitis 



The authors are grateful to Mr. Raúl Galoppe Ph.D. (Montclair State University) for his help in translating the manuscript.


  1. 1.
    Cunnane G, Doran M, Bresnihan B (2003) Infections and biological therapy in rheumatoid arthritis. Best Pract Res Clin Rheumatol 17:345–363PubMedCrossRefGoogle Scholar
  2. 2.
    Wheat JL, Kauffman CA (2003) Histoplasmosis. Infect Dis Clin North Am 17:1–19PubMedCrossRefGoogle Scholar
  3. 3.
    Wheat JL (2006) Histoplasmosis: a review for clinicians from non-endemic areas. Mycoses 49:274–282PubMedCrossRefGoogle Scholar
  4. 4.
    Doran M, Crowson CS, Pond G et al (2002) Frequency of infection in patients with Rheumatoid Arthritis compared with controls. Arthritis Rheum 46:2287–2293PubMedCrossRefGoogle Scholar
  5. 5.
    Juarez M, Misischia R, Alarcón G (2003) Infections in systemic connective tissue diseases: systemic lupus erythematosus, scleroderma, and polymyositis/dermatomyositis. Rheum Dis Clin North Am 29:163–184PubMedCrossRefGoogle Scholar
  6. 6.
    Hamilton C (2004) Infectious complications of treatment with biologic agents. Curr Opin Rheumatol 16:393–398PubMedCrossRefGoogle Scholar
  7. 7.
    Motta AC, Galo R, Grupioni Lourenço A (2006) Inusual orofacial manifestations of histoplasmosis in renal transplanted patient. Mycopathologia 161:161–165PubMedCrossRefGoogle Scholar
  8. 8.
    Voloshin DK, Lacomis D, McMahon D (1995) Disseminated histoplasmosis presenting as myositis and fasciitis in a patient with dermatomyositis. Muscle Nerve 18:531–535PubMedCrossRefGoogle Scholar
  9. 9.
    Rosenthal J, Brandt KD, Wheat J et al (1983) Rheumatologic manifestations of histoplasmosis in the recent Indianapolis epidemic. Arthritis Rheum 26:1065–1070PubMedCrossRefGoogle Scholar
  10. 10.
    Santmyire-Rosenbergera B, Dugana EM (2003) Skin involvement in dermatomyositis. Curr Opin Rheumatol 15:714–722CrossRefGoogle Scholar
  11. 11.
    Solans R, Cortés J, Vilardell M (2002) Panniculitis: a cutaneous manifestation of dermatomyositis. J Am Acad Dermatol 46:148–150CrossRefGoogle Scholar
  12. 12.
    Frias JP, Huston J, Mc Nabb P (1997) Histoplasma panniculitis in dermatomyositis. J Clin Rheumatol 3:353–357Google Scholar
  13. 13.
    Mathews JL, Ward JR, Samuelson CO et al (1983) Spontaneous nasal septal perforation in patients with rheumatoid arthritis. Clin Rheumatol 2:13–18PubMedCrossRefGoogle Scholar
  14. 14.
    Willkens R, Roth G, Novak A et al (1976) Perforation of nasal septum in rheumatic diseases. Arthritis Rheum 1976 19:119–121CrossRefGoogle Scholar
  15. 15.
    Butt AA, Carreon J (1997) Histoplasma capsulatum sinusitis. J Clin Microbiol 35:2649–2650PubMedGoogle Scholar

Copyright information

© Clinical Rheumatology 2007

Authors and Affiliations

  • F. Ceccato
    • 1
  • V. Gongora
    • 1
  • A. Zunino
    • 1
  • S. Roverano
    • 1
  • S. Paira
    • 1
    • 2
    Email author
  1. 1.Rheumatology Section, Department of Internal MedicineHospital J.M. CullenSanta FeArgentina
  2. 2.Santa FeArgentina

Personalised recommendations