title: Late occurrence of Histoplasma duboisii cutaneous and pulmonary infection 18 years after exposure.
abstract: We report an imported case of Histoplasma capsulatum var. duboisii (H. duboisii) infection in a white French woman revealed by cutaneous lesions of the scalp, 18 years after her last stay in West and Central Africa. Asymptomatic bilateral pulmonary infiltrates were discovered on thoracic computed tomography. Skin biopsy allowed the positive diagnosis showing the typical yeasts; culture of biopsy specimens was positive for H. capsulatum. In the absence of criteria of severity, the patient was treated for one year with oral itraconazole 400mg/day. The outcome was favourable, skin and pulmonary lesions resolved slowly. The follow up is 5 years without relapse after the end of treatment. This case illustrates the possibility of late occurrence of H. duboisii infection, many years after exposure and the major importance of asking any patient for travelling or residency in tropical countries.
authors.affiliation: Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France. Electronic address: elodie.regnier@yahoo.fr.
authors.forename: E
authors.initials: E
authors.lastname: Régnier-Rosencher
authors.affiliation: Department of infectious diseases, Necker hospital, AP-HP, université René-Descartes Paris V, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Dupont
authors.affiliation: Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Jacobelli
authors.affiliation: Department of parasitology and mycology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Paugam
authors.affiliation: Department of pathology, Cochin hospital, APHP, Université René-Descartes Paris V, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Carlotti
authors.affiliation: Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Boitier
authors.affiliation: Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France.
authors.forename: I
authors.initials: I
authors.lastname: Gorin
authors.affiliation: Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Dupin
authors.affiliation: Department of dermatology, Cochin hospital, AP-HP, université René-Descartes Paris V, Paris, France.
authors.forename: M F
authors.initials: MF
authors.lastname: Avril
mesh_terms: D057210:Delayed Diagnosis; D005260:Female; D006658:Histoplasma / Q000302:isolation & purification; D006660:Histoplasmosis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D008875:Middle Aged; D012536:Scalp Dermatoses / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D013997:Time Factors; D014195:Travel
chemical_list: D017964:Itraconazole
keywords: African histoplasmosis; Champignon dimorphique; Cutaneous histoplasmosis; Dimorphic fungus; Histoplasma capsulatum var. duboisii; Histoplasma capsulatum var. duboisii; Histoplasmose africaine; Histoplasmose cutanée; Histoplasmose pulmonaire; Pulmonary histoplasmosis