Vulvar infection caused by Histoplasma capsulatum: case report and literature review.

INTRODUCTION

Histoplasmosis is a systemic mycosis caused by Histoplasma capsulatum. Genital involvement is exceptional and has not been previously reported in Spain.

METHODS

We report a case of vulvar infection by H. capsulatum and review the literature to identify additional cases.

RESULTS

Four cases of vulvar histoplasmosis were identified, including the present one. All occurred in immunocompromised patients, mostly with HIV infection, and presented as vulvar lesions suggestive of neoplasia or sexually transmitted infections. In our case, a 38-year-old woman with advanced human immunodeficiency virus (HIV) infection, presented with a lesion suggestive of carcinoma. The diagnosis of histoplasmosis was confirmed by histopathology, fungal culture and molecular techniques, identifying H. capsulatum var. duboisii. All cases received antifungal therapy with favorable outcomes.

CONCLUSION

Vulvar histoplasmosis is an exceptional entity that may mimic other diseases, particularly in immunocompromised patients, and should be considered in the differential diagnosis.