Disseminated histoplasmosis in an immunocompetent infant: an uncommon diagnostic consideration.

A previously asymptomatic male infant presented with persistent fever for 4 weeks with progressive abdominal distension due to hepatosplenomegaly. Investigations were suggestive of bicytopenia. His fever was non-responsive to intravenous antibiotics. Blood and urine cultures were sterile. Bone marrow showed normal haematopoiesis with evidence of yeast forms of Histoplasma capsulatum inside erythroblasts. Urine was positive for histoplasma antigen. The infant responded to intravenous liposomal amphotericin B. Fever resolved, anaemia and thrombocytopenia recovered. Hence, we report this case of an infant with disseminated histoplasmosis presenting with fever, hepatosplenomegaly and bicytopenia.