HISTOPLASMOSIS DUE TO HISTOPLASMA-CAPSULA TUM VAR-CAPSULATUM REVEALEDBY DYSPHONIA

Histoplasmosis caused by the dimorphic fungus Histoplasma capsulatum i s a rare disease in Europe and reported cases of the disease appear to be imported. We report a case of histoplasmosis occurring in a 67-yea r-old French man who had been admitted for evaluation of oral and lary ngeal lesions associated with dysphonia. The patient, a non immunocomp romised, HIV-seronegative individual, has lived for many years in Fren ch colonies of Africa, and has visited some countries from the Middle East and North America. Initially, laryngeal cancer was suspected, but a rapid diagnosis of histoplasmosis was established cytologically, fr om oral lesion smears, and histologically, from tissue biopsy. The dia gnosis was confirmed by mycological culture. Itraconazole (200 mg dail y), together with 45 speech therapy sessions, led to complete resoluti on within 3 months. To prevent recurrence, treatment with itraconazole was continued for 3 months. Six months after the end of treatment, th e patient is free of symptoms and the dysphonia has largely regressed. Tolerance and efficacy of therapy, attested by physical examination a nd thoracic radiography, were excellent.