Histoplasmose africaine disséminée chez un enfant immunocompétent au Burkina Faso: un cas [Disseminated African Histoplasmosis in an immunocompetent child in Burkina Faso: one case]

Barro, Fatou; Traoré,; Sanwidi, Myriam; Dao, Fousséni; Korsaga, N.; Somé,; Niamba, P.; Traoré, Adama; Kam, Ludovic; Lemasson, G.

doi:10.7241/ourd.20133.91

Cited by 5 publications

(11 citation statements)

References 9 publications

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“…In our patient, there was improvement with a reduction in papules and healing of abscesses. Barro-Traoré et al (2017) reported therapeutic failure with fluconazole after 4 months and 21 days of treatment, marked by a progressive recurrence of cutaneous and lymph node lesions, worsening of bone lesions, and hepato-splenic extension [24]. Although no recurrence was observed in our patient, it is necessary to monitor lesions in patients treated with fluconazole, especially in countries where amphotericin B (the reference molecule) is not easily accessible [4].…”

Section: Discussionmentioning

confidence: 74%

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Cutaneous and Osseous Histoplasmosis caused by Histoplasma capsulatum var. duboisii in a Seemingly Immunocompetent Young Senegalese Woman

Dièye,

Seck,

Diouf

et al. 2024

AJRID

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African histoplasmosis is a rare deep mycosis caused by Histoplasma capsulatum var duboisii. It can affect various organs such as the skin, lymph nodes, and bones. The diagnosis is often delayed due to its similarity to certain diseases such as tuberculosis, cryptococcosis, pyogenic abscesses, and even neoplasia. We report a case of cutaneous and osseous histoplasmosis caused by H. capsulatum var. duboisii in a seemingly immunocompetent 19-year-old senegalese woman who presented with chronic disseminated cutaneous abscesses, some of which had fistulised, and umbilicated papules on the face. The radiograph of the right forearm showed a metaphyso-diaphyseal osteolytic lesion of the ulna. Histology after biopsy of a facial papule confirmed the diagnosis of histoplasmosis caused by H. capsulatum var duboisii. The patient's condition improved with fluconazole treatment.

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Section: Discussionmentioning

confidence: 74%

“…Our patient presented with disseminated form, however, her HIV serology was negative despite being febrile and having an altered general state. It is worth noting that some authors have described disseminated forms in immunocompetent patients who are HIV negative [21,22,23,24].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous and Osseous Histoplasmosis caused by Histoplasma capsulatum var. duboisii in a Seemingly Immunocompetent Young Senegalese Woman

Dièye,

Seck,

Diouf

et al. 2024

AJRID

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“…Diagnostic modalities for histoplasmosis used in the cases reviewed were mostly histopathology ( n = 33, 75%). Others included microscopy ( n = 3,6.8%), bone marrow aspirate and cytology ( n = 3,6.8%), culture ( n = 1,2.3%), and serology ( n = 1,2.3%) 11 – 16 , 22 – 35 , 37 , 41 – 44 , 46 Molecular diagnosis was not used in any of the cases. The diagnosis of histoplasmosis in children can be challenging.…”

Section: Resultsmentioning

confidence: 99%

Histoplasmosis in African children: clinical features, diagnosis and treatment

Ekeng

Edem

Akintan

et al. 2022

Therapeutic Advances in Infection

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Most of the reviews on histoplasmosis documented in literature have been in the adult population. Very few studies highlight the peculiarities associated with histoplasmosis in Africa especially in the pediatric population. This review addresses the above concerns with clinical summaries and diagnosis of some case reports of histoplasmosis in African children. We highlighted 44 case reports of histoplasmosis in African children (1950–2021) distributed across Western Africa (38.6%, n = 17), Eastern Africa (9.1%, n = 4), Southern Africa (9.1%, n = 4), and Central Africa (43.2%, n = 19). No case report was found from Northern Africa. The age range was 1–17 years, with a mean of 9.2. Of the 44 case reports, 8 cases (18.2%, 8/44) were caused by Histoplasma capsulatum var capsulatum, 33 cases (75%, 33/44) were caused by Histoplasma capsulatum var duboisii, and specie identification was not found in 3 cases. Only three (6.8%) cases were HIV positive; 56.8% (25/44) were disseminated histoplasmosis, pulmonary histoplasmosis accounted for just one case (2.3%, 1/44). Extrapulmonary presentation included skin lesions (ulcers, fistulas, nodules, patches, pigmentations, papules, and abscesses), bone lesions, osteoarthritis, and fractures. The commonest sites affected were skin ( n = 29, 65.9%), bones ( n = 20, 45.5%), and lymph nodes ( n = 15, 34.1%). Histopathology was the commonest diagnostic method ( n = 33, 75%). Amphotericin B was first-line therapy in 45.5% of the cases ( n = 20) followed by ketoconazole (20.5%, n = 9); 27 cases (61.4%) had favorable outcomes, 8 cases (18.2%) had fatal outcomes, while in 9 cases, the outcome was not revealed. This review revealed several cases of histoplasmosis misdiagnosed as other conditions including tuberculosis ( n = 3, 6.8%), pneumonia ( n = 1, 2.3%), cancers ( n = 4, 9.1%), nephritic syndrome ( n = 1, 2.3%), leishmaniasis ( n = 1, 2.3%), and hyperreactive malarial splenomegaly syndrome ( n = 1, 2.3%). In addition, histoplasmosis was not considered in some case reports even when symptoms were suggestive. Diagnosis of histoplasmosis was made at autopsy with postmortem findings suggestive of histoplasmosis ( n = 3, 6.8%). This report highlights the need for a paradigm shift on the part of pediatricians in Africa. They need to look beyond clinical conditions considered common in our environment for this age group and evaluate for other diseases including histoplasmosis.

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“…L'histoplasmose à Histoplasma capsulatum var. duboisii ou histoplasmose à grandes formes est une affection rare mais non exceptionnelle en Afrique [5,6]. Cette rareté pourrait probablement s'expliquer par une errance diagnostique fréquente.…”

Section: Discussionunclassified

African histoplasmosis in a child in Guinea: About a case

Diané,

Kanté,

Keita

et al. 2023

Our Dermatol Online

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African histoplasmosis is a rare deep mycosis caused by two varieties of Histoplasma capsulatum (capsulatum and duboisii). We report a case of histoplasmosis in an immunocompetent child. 6-year-old female patient, hospitalized for poor general condition, fluctuating inflammatory swelling of the lower limb evolving for 4 months. The clinical examination revealed in an altered and febrile patient, papulo-nodular lesions of variable size, fluctuating in places, disseminated umbilical predominantly on the trunk, the root of the upper and lower limbs. There were also axillary and inguinal lymphadenopathy and osteo-articular involvement. X-ray of the right lower limb revealed osteomyelitis. Histopathology of the biopsied nodule confirmed African histoplasmosis. The rarity of African histoplasmosis in our country corroborates current data from the literature, however this could also be due to an underdiagnosis often influenced by self-medication.

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Histoplasmose africaine disséminée chez un enfant immunocompétent au Burkina Faso: un cas [Disseminated African Histoplasmosis in an immunocompetent child in Burkina Faso: one case]

Cited by 5 publications

References 9 publications

Cutaneous and Osseous Histoplasmosis caused by Histoplasma capsulatum var. duboisii in a Seemingly Immunocompetent Young Senegalese Woman

Cutaneous and Osseous Histoplasmosis caused by Histoplasma capsulatum var. duboisii in a Seemingly Immunocompetent Young Senegalese Woman

Histoplasmosis in African children: clinical features, diagnosis and treatment

African histoplasmosis in a child in Guinea: About a case

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