[African histoplamosis. A report of three pediatric cases].

Autor: Mabiala Babela JR; Service de pédiatrie nourrissons, CHU de Brazzaville, Brazzaville, Congo; Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo. Electronic address: jmabialababela@yahoo.fr., Mboutol Mandavo C; Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo; Service de chirurgie pédiatrique, CHU de Brazzaville, Brazzaville, Congo., Nika Evrard R; Service de pédiatrie nourrissons, CHU de Brazzaville, Brazzaville, Congo., Ossibi Ibara B; Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo; Service de maladies infectieuses, CHU de Brazzaville, Brazzaville, Congo., Lamah L; Service de pédiatrie nourrissons, CHU de Brazzaville, Brazzaville, Congo., Ollandzobo Ikobo LC; Service de pédiatrie nourrissons, CHU de Brazzaville, Brazzaville, Congo., Mouko A; Service de pédiatrie nourrissons, CHU de Brazzaville, Brazzaville, Congo; Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo., Peko JF; Faculté des sciences de la santé, université Marien-Ngouabi, Brazzaville, Congo; Laboratoire de biologie médicale, unité d'anatomie pathologique, CHU de Brazzaville, Brazzaville, Congo.
Jazyk: francouzština
Zdroj: Journal de mycologie medicale [J Mycol Med] 2017 Jun; Vol. 27 (2), pp. 133-138. Date of Electronic Publication: 2017 Apr 24.
DOI: 10.1016/j.mycmed.2017.01.013
Abstrakt: Histoplasmosis duboisii (Histoplasma capsulatum var duboisii) is uncommon disease especially in children. It is observed in Africa where the incidence is unknown. The authors report a series of three pediatric cases. The report concerned 2 girls and one boy who were 3, 9 and 4 year-old, respectively. Symptoms evolved for more than two months in each case. At admission, we found fever and poor general condition. Observed lesions were lymphnodes localisation disseminated (cases 1 and 2), subcutaneous (cold abscess) and cutaneous simulating molluscum contagiosum (case 2), osteoarticular (cases 2 and 3), abdominal including peritoneal and hepatosplenic (case 1). In all cases, a mild leukocytosis was found and an accelerated erythrocyte sedimentation rate (ESR) greater than 70mm. The HIV serology was negative. The treatment consisted of itraconazole in 2 cases and ketoconazole in one case. The evolution was insidious, leading to the discharge against medical advice. The death occurred at home in all cases.
Conclusion: Histoplasmosis duboisii can realize two main clinical presentations (localized or disseminated), affecting the skin, lymph nodes, bones, sometimes the intra-abdominal organs. HIV serology is not always positive in disseminated forms. The evolution is unpredictable and capricious under antifungal treatment. The disease should be well explained to prevent a possible discharge against medical advice, often pejorative.
(Copyright © 2017 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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