African histoplasmosis: report of four cases from northeastern Nigeria

Khalil, M.; Hassan, AW; Gugnani, H. C.

doi:10.1111/j.1439-0507.1998.tb00341.x

Cited by 17 publications

(8 citation statements)

References 2 publications

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“…H capsulatum var. duboisii has been primarily noted in Nigeria, Niger, Congo, Democratic Republic of Congo, and Uganda 80–82 although a few cases have also been observed in Madagascar, Chad, Ivory Coast, Senegal 83–86 . Only 17 cases of H. capsulatum var.…”

Section: Global Distribution Of Histoplasmosismentioning

confidence: 99%

Histoplasmosis Infections Worldwide: Thinking Outside of the Ohio River Valley

et al. 2015

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In the United States, histoplasmosis is generally thought to occur mainly in the Ohio and Mississippi River Valleys, and the classic map of histoplasmosis distribution reflecting this is second nature to many U.S. physicians. With the advent of the HIV pandemic reports of patients with progressive disseminated histoplasmosis and AIDS came from regions of known endemicity, as well as from regions not thought to be endemic for histoplasmosis throughout the world. In addition, our expanding armamentarium of immunosuppressive medications and biologics has increased the diagnosis of histoplasmosis worldwide. While our knowledge of areas in which histoplasmosis is endemic has improved, it is still incomplete. Our contention is that physicians should consider histoplasmosis with the right constellations of symptoms in any febrile patient with immune suppression, regardless of geographic location or travel history.

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Section: Global Distribution Of Histoplasmosismentioning

confidence: 99%

Histoplasmosis Infections Worldwide: Thinking Outside of the Ohio River Valley

et al. 2015

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“…The clinical and radiological features seen in histoplasmosis have similarities with findings in TB and may account for misdiagnosis of cases of histoplasmosis as TB ( Table 4 ). 11 – 13 Even though histoplasmosis and TB are AIDS-defining illnesses, a diagnosis of histoplasmosis is rarely considered when patients with pediatric AIDS present with respiratory symptoms. 11 , 13 The high burden of TB in Africa is also a major factor that may have relegated other clinical conditions like histoplasmosis to the background.…”

Section: Resultsmentioning

confidence: 99%

“…Findings of generalized lymphadenopathy, weakness, wasting, painful facial and body swellings, abdominal distention, hepatomegaly, splenomegaly, deranged liver function tests, and abnormal hematological findings in a patient with DH are highly suggestive of a malignancy and may be misdiagnosed as such. 11 , 12 , 15 , 16 Table 6 shows some of the diagnosis considered in cases highlighted including osteosarcoma, lymphomas, neuroblastoma with orbital secondaries, facial tumor, and septicemia subsequently followed by a diagnosis of DH after a bone marrow examination or tissue biopsy. DH was not considered as a provisional or differential diagnosis in all the cases highlighted.…”

Section: Resultsmentioning

confidence: 99%

“…Unlike classical histoplasmosis which involves the lungs, African histoplasmosis commonly involves the skin and may progress to cause bone damage. 12 , 19 , 25 , 31 Localized lesions are commonly seen in immunocompetent population and may present as boils, swellings, ulcers, papules, subcutaneous abscesses, cutaneous fistulas, limb deformity, tumors, or enlarged lymph nodes. 37 , 38 , 40 , 43 , 45 Lesions may be painful or painless.…”

Section: Resultsmentioning

confidence: 99%

“… 15 , 16 , 25 , 26 , 29 The presence of lymphadenopathy on clinical examination in the pediatric age group is most often associated with TB, malignancies, and sepsis. 12 , 13 , 32 , 44 Garcia-Guiñon et al 44 report a case of DH misdiagnosed as TB in a 10-year-old girl who presented with painless suppurative lesions on the head, face, the upper body, and the armpit. A diagnosis of Histoplasma duboisii infection was subsequently made from Giemsa smear of aspirates obtained from the lesions.…”

Section: Resultsmentioning

confidence: 99%

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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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Fungal infections in the ICU

Venter

Sanne

Tropical and Parasitic Infections in the Intensive Care Unit

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African histoplasmosis: report of four cases from northeastern Nigeria

Cited by 17 publications

References 2 publications

Histoplasmosis Infections Worldwide: Thinking Outside of the Ohio River Valley

Histoplasmosis Infections Worldwide: Thinking Outside of the Ohio River Valley

Histoplasmosis in African children: clinical features, diagnosis and treatment

Fungal infections in the ICU

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