Diagnostic insights into disseminated histoplasmosis: a case report highlighting bone marrow analysis

We present a case of a 43-year-old immunocompromised female patient diagnosed with disseminated histoplasmosis on bone marrow examination, at clinical laboratory of Kasturba Hospital, Manipal, Karnataka, India. The patient, presenting with symptoms like weight loss, appetite loss, and pancytopenia, underwent bone marrow aspiration and biopsy. The bone marrow studies revealed HIV-associated changes and the yeast form of Histoplasma capsulatum, confirming disseminated histoplasmosis. Bone marrow examination is highlighted as a diagnostic tool with significant sensitivity in such cases. The report stresses on the importance of awareness and early diagnosis of histoplasmosis in immunocompromised patients, given its potential lethality and the need for timely therapeutic intervention for better prognosis

AN UNORTHODOX PRESENTATION OF SCLC

Small cell lung cancer (SCLC) is an aggressive, high-grade neuroendocrine neoplasm that possesses distinctive genetic features and clinical properties, has a highly reliable pathological diagnosis and responsiveness to specific chemotherapy. SCLC frequently presents with early metastasis, which confers a morbid prognosis. Herein we describe a 65-year-old male patient, whose preliminary investigations revealed primary SCLC with metastatic neuroendocrine carcinoma of the liver and anemia. Further analysis and a meticulous search for the unexplained anemia at diagnosis, revealed synchronous hepatic and skeletal metastases with primary small cell carcinoma of the lung. These conditions are uncommon and seldom described in the literature

Case Report Primary Amoebic Meningoencephalitis in an Infant due to Naegleria fowleri

Primary amoebic meningoencephalitis (PAM) caused by free-living amebae Naegleria fowleri is a rare and fatal condition. A fatal case of primary amoebic meningoencephalitis was diagnosed in a 5-month-old infant who presented with the history of decrease breast feeding, fever, vomiting, and abnormal body movements. Trophozoites of Naegleria fowleri were detected in the direct microscopic examination of CSF and infant was put on amphotericin B and ceftazidime. Patient condition deteriorated, and he was discharged against medical advice and subsequently expired. We also reviewed previously reported 8 Indian cases of primary amoebic meningoencephalitis (PAM) and observed that for the last 5 years, none of the patients responded to amphotericin B. Has an era of amphotericin B-resistant Naegleria fowleri been emerged? Management strategy of PAM needs to be reviewed further