Abstract
In patients undergoing treatment for hematological cancers, like hairy cell leukemia (HCL), appropriate management of infections is of utmost importance. This paper describes the successful treatment of an HCL patient who had both visceral zoster sine herpete (ZSH) and hepatosplenic fungal infection, possibly caused by Cystobasidium. To our knowledge, this is the first such case to appear in the literature, as these are rare conditions associated with states of immunosuppression, similar to those observed in hematological malignancy. Nonspecific presenting symptoms and the ineffectiveness of standard blood cultures make diagnosing these infections challenging. Newer tools, such as next-generation sequencing, may help clinicians quickly identify uncommon infections in this high-risk population of immunocompromised individuals. In addition to rare pathogens, healthcare workers must be mindful of infections that may not show typical symptoms, such as the absence of a dermatomal rash in cases of ZSH.