J R Mabiala Babela1, C Mboutol Mandavo2, R Nika Evrard3, B Ossibi Ibara4, L Lamah3, L C Ollandzobo Ikobo3, A Mouko5, J F Peko6. 1. Service de pédiatrie nourrissons, CHU de Brazzaville, Brazzaville, Congo; Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo. Electronic address: jmabialababela@yahoo.fr. 2. Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo; Service de chirurgie pédiatrique, CHU de Brazzaville, Brazzaville, Congo. 3. Service de pédiatrie nourrissons, CHU de Brazzaville, Brazzaville, Congo. 4. Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo; Service de maladies infectieuses, CHU de Brazzaville, Brazzaville, Congo. 5. Service de pédiatrie nourrissons, CHU de Brazzaville, Brazzaville, Congo; Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo. 6. Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo; Laboratoire de biologie médicale, unité d'anatomie pathologique, CHU de Brazzaville, Brazzaville, Congo.
Abstract
Histoplasmosis duboisii (Histoplasma capsulatum var duboisii) is uncommon disease especially in children. It is observed in Africa where the incidence is unknown. The authors report a series of three pediatric cases. The report concerned 2 girls and one boy who were 3, 9 and 4 year-old, respectively. Symptoms evolved for more than two months in each case. At admission, we found fever and poor general condition. Observed lesions were lymphnodes localisation disseminated (cases 1 and 2), subcutaneous (cold abscess) and cutaneous simulating molluscum contagiosum (case 2), osteoarticular (cases 2 and 3), abdominal including peritoneal and hepatosplenic (case 1). In all cases, a mild leukocytosis was found and an accelerated erythrocyte sedimentation rate (ESR) greater than 70mm. The HIV serology was negative. The treatment consisted of itraconazole in 2 cases and ketoconazole in one case. The evolution was insidious, leading to the discharge against medical advice. The death occurred at home in all cases. CONCLUSION: Histoplasmosis duboisii can realize two main clinical presentations (localized or disseminated), affecting the skin, lymph nodes, bones, sometimes the intra-abdominal organs. HIV serology is not always positive in disseminated forms. The evolution is unpredictable and capricious under antifungal treatment. The disease should be well explained to prevent a possible discharge against medical advice, often pejorative.
Histoplasmosis duboisii (Histoplasma capsulatum varduboisii) is uncommon disease especially in children. It is observed in Africa where the incidence is unknown. The authors report a series of three pediatric cases. The report concerned 2 girls and one boy who were 3, 9 and 4 year-old, respectively. Symptoms evolved for more than two months in each case. At admission, we found fever and poor general condition. Observed lesions were lymphnodes localisation disseminated (cases 1 and 2), subcutaneous (cold abscess) and cutaneous simulating molluscum contagiosum (case 2), osteoarticular (cases 2 and 3), abdominal including peritoneal and hepatosplenic (case 1). In all cases, a mild leukocytosis was found and an accelerated erythrocyte sedimentation rate (ESR) greater than 70mm. The HIV serology was negative. The treatment consisted of itraconazole in 2 cases and ketoconazole in one case. The evolution was insidious, leading to the discharge against medical advice. The death occurred at home in all cases. CONCLUSION:Histoplasmosis duboisii can realize two main clinical presentations (localized or disseminated), affecting the skin, lymph nodes, bones, sometimes the intra-abdominal organs. HIV serology is not always positive in disseminated forms. The evolution is unpredictable and capricious under antifungal treatment. The disease should be well explained to prevent a possible discharge against medical advice, often pejorative.
Authors: Bright K Ocansey; Chris Kosmidis; Martin Agyei; Améyo M Dorkenoo; Olusola O Ayanlowo; Rita O Oladele; Tchin Darre; David W Denning Journal: PLoS Negl Trop Dis Date: 2022-02-24