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[African histoplasmosis in a patient with HIV-2 infection]
Eichmann A; Schar G; Stadtische Poliklinik fur Hautkrankheiten, Zurich.
October 30, 1996
Schweiz Med Wochenschr. 1996 May 4;126(18):765-9. Unique Identifier :

9 months after immigration into Switzerland, a 38-year-old male patient from Liberia/West Africa developed granulomatous and subsequently ulcerative nodules in the face. The heterosexual patient, with no history of i.v. drug abuse, tested positive for HIV-2. Histology of a skin biopsy revealed superficial colonization by numerous fungal elements described as spores and hyphae that were compatible with the initial isolation of Candida parapsilosis. The definite diagnosis of African histoplasmosis was established 3 weeks later after review of the PAS-stained direct smear and after cultures had grown a cream-colored mold subsequently identified as Histoplasma capsulatum var. duboisii. There were no signs of disseminated disease. The lesions cleared under therapy with itraconazole (200 mg q 24h for 2 weeks, subsequently 100 mg q 24h) as well as ketoconazole and Aqua Dalibour (A. zinco-cuprica) locally for 2 months. Follow-up was not possible. Despite alarmingly increasing numbers of HIV-positive patients in Africa, the general incidence of African histoplasmosis seems to be stable with only a few cases per year. To our knowledge only four cases of disseminated African histoplasmosis have been reported in HIV-positive patients; localized cutaneous infection as in our patient, seems to be the exception. The low incidence of this infection is in contrast to the substantial number of HIV-positive patients with disseminated histoplasmosis by H. capsulatum var. capsulatum in the United States.

Acquired Immunodeficiency Syndrome/*VIROLOGY Adult Antifungal Agents/THERAPEUTIC USE AIDS-Related Opportunistic Infections/*MICROBIOLOGY Case Report Dermatomycoses/MICROBIOLOGY Drug Therapy, Combination English Abstract Facial Dermatoses/MICROBIOLOGY Histoplasma/*ISOLATION & PURIF Histoplasmosis/DRUG THERAPY/*MICROBIOLOGY Human *HIV-2 Itraconazole/ADMINISTRATION & DOSAGE Ketoconazole/ADMINISTRATION & DOSAGE Male JOURNAL ARTICLE

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