African histoplasmosis (AH) is a fungal infection due to Histoplasma capsulatum var. duboisii. Unlike classic histoplasmosis, infections caused by H. duboisii most commonly affects the skin, subcutaneous tissues, lymph nodes and bones. Till present, in Europe, all published cases have been from natives from Africa who moved to Europe. There are few reports in the literature describing the radiologic features of AH.
The authors report a case of a 7-year-old girl, from Guine-Bissau, who had multiple skin and subcutaneous lesions and left lower limb deformity. The presence of H. duboisii was confirmed by culture and histologic examination. Imaging studies were performed and showed multiple calcified and non-calcified subcutaneous lesions compatible with granulomas/abscesses; axillary and thoracic lymphadenopathies; and signs of chronic osteomyelitis. Although these imaging features are not pathognomic they should raise awareness for the diagnosis of AH in patients that are African or people who have travelled from this continent. Imaging plays a crucial role not only in the diagnosis of this disease but also in monitoring the response to therapy and detecting recurrence.
Gugnani HC, Muotoe-Okafor F. African histoplasmosis: a review. Rev Iberoam Micol. 1997 Dec;14(4):155-9.
Cockshott WP, Lucas AO. Radiological findings in Histoplasma duboisii infections. Br J Radiol. 1964 Sep;37:653-60.
Gugnani HC. Histoplasmosis in Africa: a review. Indian J Chest Dis Allied Sci. 2000 Oct-Dec;42(4):271-7.
Garcia-Guiñon A, Torres-Rodríguez JM, Ndidongarte DT, Cortadellas F, Labrín L. Disseminated histoplasmosis by Histoplasma capsulatum var. duboisii in a paediatric patient from the Chad Republic, Africa. Eur J Clin Microbiol Infect Dis. 2009 Jun;28(6):697-9.
Gonçalves D, Ferraza C, Vaz L. Posaconazole as rescue therapy in African histoplasmosis. Braz J Inf Dis. 2013;17(1):102–105.
The imaging of tropical diseases. Disponível em: http://www.isradiology.org/tropical_deseases/tmcr/chapter6/clinical29.htm. Access in 13/06/2016.
Richaud C, Chandesris MO, Lanternier F, Benzaquen-Forner H, Garcia-Hermoso D, Picard C, et. al. Imported African Histoplasmosis in an Immunocompetent Patient 40 Years after Staying in a Disease-Endemic Area. Am J Trop Med Hyg. 2014 Nov 5; 91(5): 1011–1014.
Zerbe CS, Holland SM. Disseminated histoplasmosis in persons with interferon-gamma receptor 1 deficiency. Clin Infect Dis. 2005 Aug 15;41(4):e38-41. Epub 2005 Jul 15.
Autor (es) (ou seu (s) empregador (es)) e ARP 2023. Reutilização permitida de acordo com CC BY-NC. Nenhuma reutilização comercial.