Pathology
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Histoplasma capsulatum is a pathogenic fungus endemic to North, Central, and South America. Histoplasmosis is primarily acquired by inhalation and in immunocompetent hosts infection is generally limited to the lungs. Histoplasmosis may disseminate systemically in hosts with defective cell-mediated immunity or massive inoculation. ⋯ The ovarian histoplasmosis was discovered incidentally at surgery for a persistent colo-cecal fistula, which had developed 6 months earlier and was originally associated with an Actinomyces and Fusobacterium pelvic abscess. The patient had no evidence of active pulmonary histoplasmosis and her disseminated histoplasmosis likely resulted from re-activation of latent disease. This is the first description of disseminated histoplasmosis presenting as ovarian dysfunction in a patient with SLE.