Case Report and Literature Review: Disseminated Histoplasmosis Infection Diagnosed by Metagenomic Next-Generation Sequencing

Figures & data

Table 1 Blood Test Results

Inspection Items	Day 1	Day 5	Day 12	Day18	Day 26	Reference Values
Haemoglobin (Hb) (g/L)	110	105	91	103	97	115–150
Red blood cell (RBC) count (×1012/L)	3.92	3.89	3.40	3.86	3.39	3.8–5.1
White blood cell count (×109/L)	5.46	4.40	3.24	5.31	3.07	3.5–9.5
Platelets (×109/L)	74	77	86	75	62	100–300
C-reactive protein (mg/L)	28.20	61.20	75.9	50.9	2.35	<5.00
IL-2R (μ/mL)	4450.0	4776.0	6157.0	4248.0	588.0	223–710
Procalcitonin (ng/mL)	0.45	0.54	0.42	0.18	0.04	0.046
Alanine transaminase (IU/L)	10	12	7	5	6	40
Aspartate aminotransferase (IU/L)	27	5	17	20	20	35
Total bilirubin (umol/L)	9	9.5	10.3	6.9	4.9	5.0–28.0
Serum creatinine (µmol/L)	55	55	51	99	89	48–79

Abbreviation: IL-2R, interleukin 2 receptor.

Figure 1 Abdominal CT revealed multiple cystic foci in the adnexa bilaterally (A). Chest CT showed scattered striated foci in both lungs with thickening of some lobular septa (B).

Figure 2 Wright’s staining (1000×), some phagocytes phagocytized suspected Histoplasma capsulatum in the cytoplasm (A). These fungi are surrounded by a transparent halo (B).

Figure 3 The curve of body temperature during hospitalization. Antifungal therapy with amphotericin B and v fluorouracil tablets was administered from day 5 after admission.