Progressive disseminated histoplasmosis 10 years after return out of Africa in an immunocompetent host.
We report on a patient without immunologic dysfunction who developed a reactivation of a latent histoplasma infection, acquired during a previous stay in Africa more than 10 years before. The current reactivation resulted in a subacute progressive disseminated histoplasmosis. He developed progressive weight loss, prostration and different oropharyngeal lesions together with bilateral adrenal masses on CT scan. The diagnosis was made on histology of biopsies of the oropharyngeal lesions. All systemic symptoms normalised, the oropharyngeal lesions disappeared and the adrenal masses regressed under amphotericin B therapy followed by itraconazole consolidation therapy.
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Dienst Inwendige Ziekten, Dienst Infectieziekten, Universitair Ziekenhuis Gent, De Pintelaan 185, 9000 Gent, België.
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D000666:Amphotericin B / Q000627:therapeutic use; D001530:Belgium; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D016469:Fungemia / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D006658:Histoplasma / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007121:Immunocompetence; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D013019:South Africa; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014195:Travel; D016896:Treatment Outcome
D017964:Itraconazole; D000666:Amphotericin B