Metrorrhagia in a human immunodeficiency virus positive woman caused by cervical histoplasmosis

In patients with AIDS, infection with Histoplasma capsulatum frequently results in disseminated disease. We discuss a 42-year-old HIV-infected woman presenting with fever, weight loss, pulmonary infiltrates, diarrhea, and metrorrhagia. Biopsy of bone marrow and skin demonstrated H capsulatum. Necrotic lesions of the uterine cervix, initially thought to represent cervical carcinoma, proved to be because of disseminated histoplasmosis. Involvement of the female genital tract by histoplasmosis is exceedingly rare, with cervical disease not having been described previously.