The authors report a case of multifocal African histoplasmosis with polymorphic skin involvement occuring in a patient without proven immunosuppression. He was a young 22-year-old patient from eastern Senegal - but born in Ouganda - who presented with polymorphic skin lesions: ombilicated papulo-nodules, gums and ulcerative and budding lesions. He showed lymphadenopathies without clinical inflammation and with a cheesy appearance of the biopsy but without tuberculosis and also hepatosplenic and bone involvement. Mycological samples of the skin and lymph nodes biopsies revealed yeasts of Histoplasma capsulatum var. duboisii with a positive culture on Sabouraud medium. HIV serology, HTLV1et 2, the serum proteins electrophoresis were unremarkable. Treatment with amphotericin B was irregular because of its inaccessibility in the national territory and its cost. The patient died of sepsis together with the aggravation of his disease.
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| http://dx.doi.org/10.1016/j.mycmed.2016.03.004 | DOI Listing |
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- The authors reviewed 72 cases worldwide, primarily from the Americas, finding that many patients had underlying conditions, such as HIV and haemophagocytic lymphohistiocytosis.
- Recovery rates were relatively high at 73.6%, but significant mortality was attributed to diagnostic delays and complications, indicating that early recognition of pancytopenia may be crucial for better patient outcomes.
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