[en] Case report: We report the case of a young Cameroonian woman who presented with cough,
hyperthermia, weight loss, pancytopenia, and hepatosplenomegaly. A positive HIV serology
was discovered and a chest radiography revealed a ‘miliary pattern’. Bone marrow aspiration
pointed out yeast inclusions within macrophages. Given the morphological aspect, the clinical
presentation and immunosuppression, histoplasmosis was retained as a working hypothesis.
Antiretroviral and amphotericin B treatments were promptly initiated.
Review: Given the immigration wave that Europe is currently experiencing, we think it is
important to share experience and knowledge, especially in non-endemic areas such as
Europe, where clinicians are not used to face this disease. Histoplasmosis is due to Histoplasma
capsulatum var. capsulatum, a dimorphic fungus. Infection occurs by inhaling spores contained
in soils contaminated by bat or bird droppings. The clinical presentation depends on the immune
status of the host and the importance of inoculum, varying from asymptomatic to disseminated
forms. AIDS patients are particularly susceptible to develop a severe disease. Antigen detection,
molecular biology techniques, and microscopic examination are used to make a rapid diagnosis.
However, antigen detection is not available in Europe and diagnosis needs a strong clinical
suspicion in non-endemic areas. Because of suggestive imagery, clinicians might focus on
tuberculosis. Our case illustrates the need for clinicians to take histoplasmosis
Disciplines :
Animal production & animal husbandry
Author, co-author :
Evrard, Séverine; Centre Hospitalier Régionale de la Citadelle (Liège) - CHR CITADELLE > Laboratoire médical
CAPRASSE, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > Service des maladies infectieuses - médecine interne
Gavage, Pierre; Centre Hospitalier Régionale de la Citadelle (Liège) - CHR CITADELLE > Laboratoire médical
Vasbien, Myriam; Centre Hospitalier Régionale de la Citadelle (Liège) - CHR CITADELLE > Laboratoire médical
Radermacher, Jean; Centre Hospitalier Régionale de la Citadelle (Liège) - CHR CITADELLE > Anatomopathologie
HAYETTE, Marie-Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Service de microbiologie clinique
SACHELI, Rosalie ; Centre Hospitalier Universitaire de Liège - CHU > Service de microbiologie clinique
Van Esbroeck, Marjan; Institut de Médecine Tropicale Anvers > Sciences cliniques
Cnops, Lieselotte; Institut de médecine Tropicale Anvers > Sciences cliniques
Firre, Eric; Centre Hospitalier Régionale de la Citadelle (Liège) - CHR CITADELLE > Infectiologie
Médart, Laurent; Centre Hospitalier Régionale de la Citadelle (Liège) - CHR CITADELLE > Radiologie
Moerman, Philippe; Centre Hospitalier Régionale de la Citadelle (Liège) - CHR CITADELLE > Infectiologie
Minon, Jean-marc; Centre Hospitalier Régionale de la Citadelle (Liège) - CHR CITADELLE > Laboratoire medical
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