P-021 Disseminated Histoplasmosis in a Food Service Company Employee: A Case Report From Buenos AIres, Argentina

Introduction Histoplasmosis is a fungal infection caused by the inhalation of conidia of Histoplasma. Disseminated histoplasmosis is characterized by progressive granulomatous disease usually associated with immunosuppression. The objective of this communication is to report a case of disseminated histoplasmosis in a food service company employee. Material and Methods In 2022, in Buenos Aires, a 29-year-old male employee of a food service company with acquired immunodeficiency syndrome (HIV-AIDS) diagnosed in 2017, consulted for weight loss, multiple lymphadenopathies, fever and nocturnal sweats. Radiology demonstrated disseminated micronodular images that were interpreted as tuberculosis (TB). After three weeks of TB treatment, violaceous papule-type skin lesions appeared in the upper limbs and thorax. The skin biopsy showed fungal encapsulated yeasts suggestive of Histoplasma. The anti-fungal treatment was carried out successfully. Results Histoplasma mainly lives in the soil and environments that contain large accumulations of bird or bat droppings. Bridge, construction, excavation or demolition workers, farmers, gardeners, landscapers and microbiology laboratory workers are the occupations usually exposed to histoplasma. Most people who inhale the spores do not get sick but in people with weakened immune systems, the infection often becomes disseminated and simulates TB. Conclusion Histoplasma spores in the food service environment are not usual. This case should not be considered as an occupational disease because the development of the histoplasmosis was related not to the work itself, but to immunosuppression due to non-occupational HIV-AIDS.