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Abstract - Disseminated Histoplasmosis Post-IL6 Inhibitor Use in A COVID-19 Patient
Brijesh Sharma, Premapassan Krishnamurthy, Desh Deepak, Shailja Shukla, Vishakha Arya, Anuradha Chowdhary

Disseminated Histoplasmosis Post-IL6 Inhibitor Use in A COVID-19 Patient

Premmapassan Krishnamurthy1, Brijesh Sharma1, Desh Deepak1, Shailaja Shukla3, Vishakha Arya3, Anuradha Chowdhary4

 

1Department of Medicine, Dr. Ram Manohar Lohia Hospital, New Delhi, India

2Department of Respiratory Medicine, Dr. Ram Manohar Lohia Hospital, New Delhi, India

3Department of Pathology, Lady Hardinge Medical College & Smt. S. K. Hospital, New Delhi, India

4Department 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.

Keywords: COVID-19, IL6 inhibitor, Histoplasmosis

Volume 11, Number 03 (2021)