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Disseminated histoplasmosis — RCPSC IM MCQ

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HardInfectious DiseasesDisseminated histoplasmosisRCPSC IM

A 57-year-old man from northern Ontario has fever, weight loss, pancytopenia, hepatosplenomegaly, and diffuse lymphadenopathy. HIV test is positive with CD4 count 38 cells/microlitre. Bone marrow biopsy shows intracellular yeasts within macrophages. What is the most likely diagnosis?

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Correct answer: E — Disseminated histoplasmosis

Advanced HIV with fever, pancytopenia, hepatosplenomegaly, and intracellular yeasts in macrophages is typical of disseminated histoplasmosis.

Reference: Canadian HIV care resources; opportunistic infection guidance