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Figures
- FIGURE 1
At presentation, the patient had a sparse, erythematous, macular, nonblanching rash on the lower and upper limbs.
- FIGURE 2
Repeat chest radiography showed a new right basilar consolidation with a small effusion (arrow).
Tables
Current admission Recent admission Reference range White blood cell count 10.0 8.8 4.0–10.0 × 109/L Lymphocytes 6.1a Not available 1.2–3.4 × 109/L Hemoglobin 13.6 13.2 14.0–18.0 g/dL Platelets 87 136 150–400 × 109/L Albumin 47 28 35–50 g/L Total bilirubin 48 20 2–20 μmol/L Alkaline phosphatase 137 314 40–135 U/L Alanine aminotransferase 22 193 9–69 U/L Aspartate aminotransferase 72 130 5–45 U/L Erythrocyte sedimentation rate Not available 29 0–20 mm/hour ↵a Abnormal values are shown in bold.
Histoplasmosis Coccidioidomycosis Blastomycosis Culture Positive in 75% High yield High yield Urine antigen detection 75%–90% sensitivity
Cross-reactivity with blastomycosis, paracoccidioidomycosisSensitivity and specificity not known 93% sensitivity
95.6% cross-reactivity with histoplasmosisSerologic testing High sensitivity
Cross-reactivity with blastomycosis and coccidioidomycosisHigh sensitivity and specificity Not useful
Poor sensitivity
Significant cross-reactivity with histoplasmosisNucleic acid testing Uncertain value Under development 86% sensitivity
99% specificity
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