Articles | Volume 6, issue 8
https://doi.org/10.5194/jbji-6-355-2021
https://doi.org/10.5194/jbji-6-355-2021
Case report
 | 
23 Sep 2021
Case report |  | 23 Sep 2021

Left hand extensor tenosynovitis due to Histoplasma capsulatum complicated by immune reconstitution inflammatory syndrome

Talha Riaz, Mark Collins, Mark Enzler, Marco Rizzo, Audrey N. Schuetz, Julia S. Lehman, Douglas Osmon, and Irene G. Sia

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Cited articles

Assi, M. A., Sandid, M. S., Baddour, L. M., Roberts, G. D., and Walker, R. C.: Systemic histoplasmosis: a 15-year retrospective institutional review of 111 patients, Medicine (Baltimore), 86, 162–169, 2007. 
Cucurull, E., Sarwar, H., Williams, C. St., and Espinoza, L. R.: Localized tenosynovitis caused by Histoplasma capsulatum: case report and review of the literature, Arthritis Rheum., 53, 129–132, 2005. 
Filali, S. M., Faik, A., Allali, F., Jahid, A., Chihab, W., El Hassani, S., and Hassouni, N. H.: Histoplasma capsulatum tenosynovitis in a patient with rheumatoid arthritis-scleroderma overlap syndrome, Joint Bone Spine., 73, 479–481, 2006. 
Hage, C. A., Bowyer, S., Tarvin, S. E., Helper, D., Kleiman, M. B., and Wheat, L. J.: Recognition, diagnosis, and treatment of histoplasmosis complicating tumor necrosis factor blocker therapy, Clin. Infect. Dis., 50, 85–92, 2010. 
Houtman, P. M., Marck, K. W., and Hol, C.: Histoplasmosis of the wrist: a case report, Rheumatology, 38, 906–907, 1999. 
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Short summary
Tenosynovitis due to Histoplasma capsulatum in an immunocompromised host warrants special attention. Following surgical debridement, the patient initially improved on antifungal therapy, but as immunosuppression was decreased, she presented with a flare, requiring further debridement. With negative fungal cultures and declining antigenemia, it was felt that her interim worsening was as a consequence of immune reconstitution inflammatory syndrome (IRIS).