Hepatic Histoplasmosis Masquerading as Cirrhosis and Portal Hypertension: A Case Report

Abstract

AbstractHistoplasmosis is an uncommon cause of pyrexia of unknown origin in India. We present a case of hepatic histoplasmosis presenting as pyrexia of unknown origin. The patient had splenomegaly, thrombocytopenia, high serum-ascites albumin gradient, and imaging suggestive of cirrhosis. The patient had received 2 months of antitubercular treatment and came to us because of a lack of improvement. A liver biopsy was done because of cholestatic liver function tests and normal biliary system on imaging, thus raising the possibility of infiltrative liver disease. A transjugular liver biopsy revealed histoplasmosis. The patients improved after treatment. It is a common practice to start antitubercular treatment in patients with pyrexia of unknown origin, which should not be practiced in the current era. Every effort should be made for a correct diagnosis. The case highlights the importance of liver biopsy in cases with no definite diagnosis and also that hepatic histoplasmosis could mimic cirrhosis.