Histoplasmosis in the Republic of Congo dominated by African histoplasmosis, Histoplasma capsulatum var. duboisii.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101291488 Publication Model: eCollection Cited Medium: Internet ISSN: 1935-2735 (Electronic) Linking ISSN: 19352727 NLM ISO Abbreviation: PLoS Negl Trop Dis Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Bone and Bones/*microbiology ; Histoplasma/*isolation & purification ; Histoplasmosis/*drug therapy ; Histoplasmosis/*epidemiology ; Lymph Nodes/*microbiology ; Skin/*microbiology; Adolescent ; Adult ; Amphotericin B/therapeutic use ; Antifungal Agents/therapeutic use ; Bone and Bones/pathology ; Child ; Child, Preschool ; Congo/epidemiology ; Environmental Exposure/adverse effects ; Female ; Histoplasma/classification ; Histoplasma/drug effects ; Histoplasmosis/diagnosis ; Humans ; Infant ; Itraconazole/therapeutic use ; Lymph Nodes/pathology ; Male ; Middle Aged ; Skin/pathology ; Young Adult

The Republic of Congo (RoC) is one of the African countries with the most histoplasmosis cases reported. This review summarizes the current status regarding epidemiology, diagnostic tools, and treatment of histoplasmosis in the RoC. A computerized search was performed from online databases Medline, PubMed, HINARI, and Google Scholar to collect literature on histoplasmosis in the RoC. We found 57 cases of histoplasmosis diagnosed between 1954 and 2019, corresponding to an incidence rate of 1-3 cases each year without significant impact of the AIDS epidemic in the country. Of the 57 cases, 54 (94.7%) were cases of Histoplasma capsulatum var. duboisii (Hcd) infection, African histoplasmosis. Three cases (5.3%) of Histoplasma capsulatum var. capsulatum infection were recorded, but all were acquired outside in the RoC. The patients' ages ranged between 13 months to 60 years. An equal number of cases were observed in adults in the third or fourth decades (n = 14; 24.6%) and in children aged ≤15 years. Skin lesions (46.3%), lymph nodes (37%), and bone lesions (26%) were the most frequent clinical presentations. Most diagnoses were based on histopathology and distinctive large yeast forms seen in tissue. Amphotericin B (AmB) was first line therapy in 65% of the cases and itraconazole (25%) for maintenance therapy. The occurrence of African histoplasmosis in apparently normal children raises the possibility that African histoplasmosis is linked to environmental fungal exposure.
Competing Interests: The authors have declared that no competing interests exist.

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0 (Antifungal Agents)
304NUG5GF4 (Itraconazole)
7XU7A7DROE (Amphotericin B)

Date Created: 20210506 Date Completed: 20210914 Latest Revision: 20210914

20240829

PMC8101734

10.1371/journal.pntd.0009318

33956817