Disseminated histoplasmosis with skin manifestations in advanced HIV: Case report.

Background: Histoplasmosis is a systemic mycosis caused by the agent Histoplasma capsulatum. Its clinical manifestations depend on the inhaled fungal load and can vary from an asymptomatic infection (90%) to a disseminated disease, especially in HIV infections and a CD4 T lymphocyte count of less than 150 cells. Its initial symptoms are nonspecific, including fever, weight loss, dry cough, and chest pain. It spreads to other organs, with the skin being a rare site where lesions of wide polymorphism are observed. The disseminated form requires a high index of suspicion and must be differentiated from other common pathologies in patients with advanced HIV infection such as pulmonary tuberculosis. Clinic case: A 33-year-old male with a diagnosis of HIV/AIDS C3, pulmonary tuberculosis and dermatosis of 9 months' evolution, with poor adherence to treatment who died of complications secondary to disseminated histoplasmosis. Conclusion: Histoplasmosis is a common opportunistic mycosis in patients with advanced HIV disease, especially in endemic areas, so it's recommended to start an early diagnostic protocol and raise awareness of the importance of adherence to treatment, due to the rapid progression of the disseminated variant and its high mortality.