{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T15:12:18Z","timestamp":1777907538811,"version":"3.51.4"},"reference-count":5,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trop Doct"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>A 56-year old immuno-competent male from a non-endemic region in India presented with progressive weight loss, hoarseness of voice and widespread cutaneous lesions, including leonine facies, genital nodules and diffuse scaling. Magnetic resonance imaging of the neck revealed oedematous thickening of the false vocal cords, epiglottis and aryepiglottic folds, suggesting laryngeal involvement. All routine investigations were normal. Urine Histoplasma antigen levels were markedly elevated. Skin biopsy revealed granulomatous inflammation with intracellular yeast-like organisms, and polymerase chain reaction confirmed Histoplasma capsulatum DNA. A diagnosis of disseminated histoplasmosis with probable laryngeal involvement was made. The patient responded well to liposomal amphotericin B followed by itraconazole for 12 months. Although histoplasmosis commonly affects immunocompromised individuals, its rising incidence in immuno-competent patients from non-endemic regions necessitates greater clinical vigilance and emphasises the role of dermatological assessment and targeted fungal testing in systemic mycoses.<\/jats:p>","DOI":"10.1177\/00494755251375197","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T11:19:12Z","timestamp":1757071152000},"page":"148-150","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Leonine facies and hoarseness in disseminated histoplasmosis: A diagnostic pitfall"],"prefix":"10.1177","volume":"56","author":[{"given":"Divya","family":"Priyadarshi","sequence":"first","affiliation":[{"name":"Senior Resident, Department of Dermatology, Venereology and Leprosy, King George's Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atin","family":"Singhai","sequence":"additional","affiliation":[{"name":"Professor, Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6218-2175","authenticated-orcid":false,"given":"Immaculata","family":"Xess","sequence":"additional","affiliation":[{"name":"Professor, Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6952-1037","authenticated-orcid":false,"given":"Swastika","family":"Suvirya","sequence":"additional","affiliation":[{"name":"Professor and Head, Department of Dermatology, Venereology and Leprosy, King George's Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/521259"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2012.01.004"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.4102\/sajhivmed.v18i1.693"},{"key":"e_1_3_2_5_2","first-page":"70","article-title":"A case of disseminated histoplasmosis presenting with facial and laryngeal involvement","volume":"86","author":"Sondhi P","year":"2020","unstructured":"Sondhi P, Singh S, Khandpur S, et al. A case of disseminated histoplasmosis presenting with facial and laryngeal involvement. Indian J Dermatol Venereol Leprol 2020; 86: 70.","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmoldx.2021.02.007"}],"container-title":["Tropical Doctor"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00494755251375197","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00494755251375197","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00494755251375197","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:37:31Z","timestamp":1777642651000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00494755251375197"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/00494755251375197"],"URL":"https:\/\/doi.org\/10.1177\/00494755251375197","relation":{},"ISSN":["0049-4755","1758-1133"],"issn-type":[{"value":"0049-4755","type":"print"},{"value":"1758-1133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,5]]}}}