A 31-year-old male was admitted with biopsy confirmed cutaneous histoplasmosis. He had developed plaques a few months prior to commencing ART. His baseline CD4 count was 29 cells/mm3 in August 2013. A viral load and CD4 count at 3 months of ART were 580 copies/mm3 and 278 cells/mm3, respectively. He was referred for investigation of pancytopenia.  Table 3 shows his baseline blood results. A bone marrow aspiration as well as biopsy was undertaken to investigate for fungal infiltration of the bone marrow but the biopsy showed AFB. He was commenced on rifampicin, isoniazid, ethambutol, and pyrazinamide. A day later the SD Bioline MPT64 TB Antigen Rapid result was negative. Clarithromycin was added to the TB treatment to effectively treat the disseminated nontuberculous mycobacteria infection. Culture revealed NTM but PCR failed to determine the species.
At his 6-month follow-up visit he had a normal full blood count. Follow-up blood results are captured in Table 2. He continues his TB treatment together with clarithromycin and ART.