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H&E stain of bone marrow core biopsy showing small spherical objects (stars) with a peripheral halo in many of the histiocytes.

HLH with Histoplasmosis




The patient has both Hemophagocytic lymphohistiocytosis and fungal elements compatible with Histoplasma. A positive galactomannan antigen was also found in the patient's urine, which further supported a diagnosis of disseminated histoplasmosis.  

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