case_images: PMC9812595_01
case_images: Initial bone marrow aspiration showing myelodysplasia syndrome (MDS) with refractory cytopenia with multilineage dysplasia (RCMD) subtype and infection with H. capsulatum inside the macrophages (taken 2 weeks after admission and as the initial point to start antifungal treatment).
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case_images: fig1
case_images: The result was a myelodysplasia syndrome (MDS) with a refractory cytopenia multilineage dysplasia (RCMD) subtype and infection with Histoplasma capsulatum (Figure 1).
case_images: Bone marrow aspiration after 4 weeks of antifungal treatment showed the reduction of intracellular budding yeast of Histoplasma inside the macrophages.
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case_images: fig2
case_images: The sequential BMA revealed a gradual loss leading to complete clearance of H. capsulatum within ten weeks of treatment (Figures 2 and 3).
case_images: Bone marrow aspiration after 10 weeks of antifungal treatment showed macrophages without Histoplasma.
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case_images: fig3
case_images: The sequential BMA revealed a gradual loss leading to complete clearance of H. capsulatum within ten weeks of treatment (Figures 2 and 3).
case_images: Improvement in peripheral blood parameters following treatment with an antifungal in case 1.
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case_images: fig4
case_images: The blood evaluation during treatment is shown in Figure 4.
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case_images: Large ecchymosis in the lower extremities.
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case_images: fig5
case_images: He presented with several large ecchymoses in his lower extremities and trunk (Figure 5).
case_images: Bone marrow aspiration at the time of diagnosis showed Histoplasma capsulatum yeasts inside the macrophages.
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case_images: fig6
case_images: The BMA smear showed hemophagocytic lymphohistiocytosis (HLH) with abundant H. capsulatum inside the macrophage cells with dyserythropoiesis and dysgranulopoiesis (Figure 6).
case_images: Histoplasma capsulatum yeast in methylene blue (a) and KOH (b) staining taken 5 weeks after starting BMA culture in Sabouraud agar.
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case_images: fig7
case_images: The isolate was subsequently taken after 5 weeks and stained with methylene blue and KOH (Figure 7).
case_images: Improvement in peripheral blood parameters following treatment with an antifungal in case 2.
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case_images: PMC9812595_02_CRIM2022-9521128.008.jpg
case_images: fig8
case_images: The blood evaluation during treatment is shown in Figure 8.