African histoplasmosis: therapeutic efficacy of itraconazole

Abstract

A patient with African form of histoplasmosis was treated for 7 years with ketoconazole, with no response; after a 9-month daily treatment with 100 mg of itraconazole the patient was successfully cured. No evidence of relapse was observed during the 3-year follow-up period.

Une histoplasmose africaine chez un patient malgache immunocompétent

“…L'expression clinique est souvent localisée (70 %). Elle intéresse la peau (31 %), les os (24 %) et les ganglions (6 %) [9].…”

“…Plusieurs auteurs utilisent en premier lieu l'itraconazole, le kétoconazole ou le fluconazole dans le traitement de l'histoplasmose africaine [6,9]. En cas d'inefficacité clinique ou d'une menace du pronostic vital, l'itraconazole peut être remplacé par l'amphotéricine B [6].…”

“…Elle est retrouvée presque exclusivement en Afrique de l'Ouest et centrale, et rarement à Madagascar [1,2,8]. Les principales localisations sont la peau, les ganglions et les os [9].…”

Vaginal Ulceration and Local Lymphadenopathy in an African Immigrant

“…Amphotericin B is the drug of choice in treating severe and disseminated cases; however, itraconazole and ketoconazole have shown good results in a large number of cases [4,5,7,9]. Treatment for at least 6 months is mandatory, because the risk of relapse is greater with shorter durations of treatment [12].…”

“…In contrast with the regions of endemicity, where African histoplasmosis is common, Europe experiences few cases, with 23 documented cases since 1980, 6 of which involved patients with AIDS [4,[6][7][8][9][10][11].…”