{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:02:11Z","timestamp":1790413331714,"version":"4.1.0"},"reference-count":33,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Direccion General de Investigacion y Vinculacion (DGIV) de la Universidad de las Am\u00e9ricas (UDLA)","award":["MED.MCH.21.03"],"award-info":[{"award-number":["MED.MCH.21.03"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Histoplasmosis is an endemic mycosis in the Americas. However, its diagnosis is challenging due to the complexity and limited availability of conventional laboratory techniques\u2014antigen tests, culture, and staining. Microscopic preparations often confuse with other pathogens, such as Leishmania spp. The genus Histoplasma\u00a0capsulatum comprises three varieties: var. capsulatum, var. duboissi, and var. farciminosum, which cannot be distinguished using conventional techniques. An infant from a tropical region of Ecuador was hospitalized for fever, bloody diarrhea, and anemia persisting for two months. Upon admission, he received antibiotics and immunosuppressants. Histopathological examination of the lymph nodes, intestines, and bone marrow aspirate reported the presence of Leishmania-like amastigotes, and treatment was initiated with meglumine antimoniate and conventional amphotericin B. However, subsequent analysis of samples using PCR and DNA sequencing identified H.\u00a0capsulatum var. capsulatum but not Leishmania. Despite fluconazole and amphotericin B, the infant succumbed to the disease. The delay in clinical and laboratory diagnosis of histoplasmosis and the use of nonspecific and ineffective drugs such as fluconazole led to disease dissemination and, ultimately, death. Implementing molecular diagnosis and antigen tests in laboratories located in endemic regions and reference hospitals is crucial.<\/jats:p>","DOI":"10.3390\/pathogens12091112","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T09:44:46Z","timestamp":1693388686000},"page":"1112","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A Fatal Case of Disseminated Histoplasmosis by Histoplasma capsulatum var. capsulatum Misdiagnosed as Visceral Leishmaniasis\u2014Molecular Diagnosis and Identification"],"prefix":"10.3390","volume":"12","author":[{"given":"Manuel","family":"Calvopi\u00f1a","sequence":"first","affiliation":[{"name":"One Health Research Group, Universidad de Las Am\u00e9ricas (UDLA), Quito 170124, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Toro","sequence":"additional","affiliation":[{"name":"Hospital Pedi\u00e1trico \u201cBaca Ortiz\u201d, Quito 170523, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5364-7700","authenticated-orcid":false,"given":"Carlos","family":"Bastidas-Caldes","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de Las Am\u00e9ricas (UDLA), Quito 170124, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0546-8345","authenticated-orcid":false,"given":"David","family":"Vasco-Julio","sequence":"additional","affiliation":[{"name":"Programa de Posgrado en Ciencias Biol\u00f3gicas, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City 04510, Mexico"},{"name":"Centro de Investigaci\u00f3n Sobre Enfermedades Infecciosas, Instituto Nacional de Salud P\u00fablica, Cuernavaca 62050, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Hospital Pedi\u00e1trico \u201cBaca Ortiz\u201d, Quito 170523, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lockhart, S.R., Toda, M., Benedict, K., Caceres, D.H., and Litvintseva, A.P. 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