title: [Aspergillus galactomannan assay for the management of histoplasmosis due to Histoplasma capsulatum var. duboisii in HIV-infected patients: education from a clinical case].
abstract: The diagnosis of histoplasmosis due to Histoplasma capsulatum var capsulatum is based on a direct examination identifying encapsulated yeast with narrow-based budding. Galactomannan antigenemia facilitates diagnosis, as well as the monitoring of patients receiving treatment. The case of a HIV-positive patient from Congo-Brazzaville with a disseminated form of African histoplasmosis highlighted the positive galactomannan antigen in this disease due to Histoplasma capsulatum var duboisii. Galactomannan antigenemia remained high with a very slow decrease during antifungal therapy and slow regression of clinical lesions. African histoplasmosis is a rare disease that is difficult to diagnose and rarely described in immunocompromised patients, in whom differential diagnosis can be common. This observation underlines the importance of the galactomannan antigen assay in patients who have travelled to endemic areas. As in the case of Histoplasma capsulatum var capsulatum, the positivity of the Aspergillus galactomannan antigen is very useful in the diagnosis and monitoring of African histoplasmosis.
authors.affiliation: Service de médecine interne, maladies infectieuses et tropicales, centre hospitalier de Versailles, 78150 Le Chesnay, France.
authors.forename: A
authors.initials: A
authors.lastname: Therby
authors.affiliation: Parasitologie, unité de microbiologie, département de biologie, hôpital André-Mignot, centre hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay, France.
authors.forename: O
authors.initials: O
authors.lastname: Polotzanu
authors.affiliation: Service de médecine interne, maladies infectieuses et tropicales, centre hospitalier de Versailles, 78150 Le Chesnay, France.
authors.forename: D
authors.initials: D
authors.lastname: Khau
authors.affiliation: Service de médecine interne, maladies infectieuses et tropicales, centre hospitalier de Versailles, 78150 Le Chesnay, France.
authors.forename: S
authors.initials: S
authors.lastname: Monnier
authors.affiliation: Service de médecine interne, maladies infectieuses et tropicales, centre hospitalier de Versailles, 78150 Le Chesnay, France.
authors.forename: A
authors.initials: A
authors.lastname: Greder Belan
authors.affiliation: Parasitologie, unité de microbiologie, département de biologie, hôpital André-Mignot, centre hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay, France. Electronic address: oeloy@ch-versailles.fr.
authors.forename: O
authors.initials: O
authors.lastname: Eloy
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000276:immunology; D000328:Adult; D000946:Antigens, Fungal / Q000032:analysis*; D001230:Aspergillus / Q000276:immunology*; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D015658:HIV Infections / Q000150:complications / Q000276:immunology; D006658:Histoplasma / Q000276:immunology / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000175:diagnosis*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D008351:Mannans / Q000032:analysis*; D011237:Predictive Value of Tests
chemical_list: D000946:Antigens, Fungal; D008351:Mannans; C012990:galactomannan; D005690:Galactose
keywords: African histoplasmosis; Galactomannan; Galactomannane; HIV; Histoplasma capsulatum var. duboisii; Histoplasmose africaine; VIH