F. Simon et al., BONE AND JOINT INVOLVEMENT IN AFRICAN HISTOPLASMOSIS (HISTOPLASMA-DUBOISII) - REPORT OF A CASE AND REVIEW OF THE LITERATURE, Revue du rhumatisme, 61(11), 1994, pp. 739-747
The authors report a case of disseminated African histoplasmosis with
bone and joint involvement in a black 28-year-old citizen of the Centr
al African Republic who presented with a 17-month history of multiple
osteoarticular lesions (sternoclavicular joints, humerus, ribs), cutan
eous lesions (face, scalp, thorax), and lymphadenopathy. Clinical mani
festations resolved rapidly under treatment with ketoconazole (600 mg/
d for 10 days then 400 mg/day for nine months). Persistent yeast cells
were then found upon examination of a lymph node biopsy specimen. The
characteristics and diagnosis of osteoarticular lesions due to Africa
n histoplasmosis are discussed on the basis of a review of the literat
ure. Bone and joint lesions due to African histoplasmosis have not yet
been reported in patients with the acquired immunodeficiency syndrome
. However, the expanding epidemic of human immunodeficiency virus infe
ction in Africa can be expected to result in an increase in the incide
nce of African histoplasmosis. Imidazole derivatives are easier to use
on a long-term basis than amphotericin B and have significantly impro
ved our ability to treat African histoplasmosis.