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May 23, 1977

Idiopathic Thrombocytopenic Purpura in Patients With Histoplasmosis

Author Affiliations

From the Division of Hematology-Oncology, Department of Internal Medicine, College of Medicine, the University of Iowa and University Hospitals, Iowa City (Drs Armitage and Sheets).

JAMA. 1977;237(21):2323-2324. doi:10.1001/jama.1977.03270480063024

THROMBOCYTOPENIC purpura has been reported secondary to a multiplicity of causes.1 However, idiopathic thrombocytopenic purpura (ITP), in relation to infectious diseases other than viral illnesses, is unusual. We report two cases where ITP developed with the onset of histoplasmosis.

Report of Cases 

Case 1.—  A 41-year-old woman was referred to the University of Iowa Hospitals on July 3, 1970, with a two-week history of fevers, chills, headache, nonproductive cough, and a 7-kg weight loss. She had failed to respond to oral antibiotic therapy. She had been in good health prior to the onset of the aforementioned symptoms, and there was no antecedent history of easy bleeding, bruising, or hematologic abnormality. The patient appeared severely ill and was febrile. Neither lymphadenopathy nor hepatosplenomegaly was found. Pulmonary and cardiovascular examination results were unremarkable. Petechiae and ecchymoses were not observed. Initial laboratory studies included a WBC count of 7,400/cu mm, with 81%