Volume 13, Number 11—November 2007
Synopsis
Literature Review and Case Histories of Histoplasma capsulatum var. duboisii Infections in HIV-infected Patients
Pierre Loulergue*†, Frédéric Bastides‡, Véronique Baudouin§, Jacques Chandenier‡, Patricia Mariani-Kurkdjian§, Bertrand Dupont*†, Jean-Paul Viard*†, Françoise Dromer¶, and Olivier Lortholary†¶
Table 1
Description of HIV-infected patients with histoplasmosis due to Histoplasma capsulatum var. duboisii*
| Case no.† | Age, y | Sex | Country | Clinical findings | CD4 count/mm3 | Pathology | Positive fungal culture | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|
| 1 | 20 | F | Congo | Skin lesions | NR | Skin | – | AmB 1 mg/kg/d, Itr 300 mg/d | Relapse |
| 2 | 44 | M | Congo | Skin lesions, weight loss, lymph nodes, peritonitis | NR | Skin, pus | – | Ketoconazole 600 mg/d, AmB, Itr 300 mg/d | Relapse |
| 3 | 41 | M | Congo | Skin lesions, weight loss, lymph nodes, hepatomegaly, splenomegaly | NR | Skin | – | AmB | Death |
| 4 | 65 | M | DRC | Fever, weight loss, anemia | NR | Bone marrow | Bone marrow, blood | AmB | Death |
| 5 | 28 | M | DRC | Fever, skin lesions, lymph nodes, weight loss, bone lesions | NR | Skin | Skin | Ketoconazole 600 mg/d | NR |
| 6 | 31 | F | Cameroon | Septic shock | 2 | Bone marrow | Bone marrow, blood | ABLC 5 mg/kg/d, Itr 400 mg/d | No relapse |
| 7 | 29 | M | Liberia | Skin lesions | NR | Skin | Skin | Itr 200 mg/d | NR |
| 8 | 43 | F | Guinea-Bissau | Fever, weight loss, anemia, abdominal pain | 68 | Colon | – | Itr 400 mg/d | No relapse |
| 9 | 30 | M | Nigeria | Fever, skin lesions, lymph nodes, anemia | 2 | Skin | Skin | AmB 1 mg/kg/d, Itr 400 mg/d | Relapse |
| 10 | 38 | M | DRC | Fever, weight loss, lymph nodes | 160 | Lymph nodes | Bone marrow, lymph nodes | AmB | No relapse |
| 11 | 26 | M | Congo | Fever, skin lesions, lymph nodes | NR | Lymph nodes | – | AmB 1 mg/kg/48 h | No relapse |
| 12 | 30 | M | Côte d’Ivoire | Fever, weight loss, lymph nodes | 6 | Bone marrow | – | Itr 400 mg/d | No relapse |
| 13 | 50 | F | Nigeria | Skin lesions, bone lesions | NR | Skin, bone | – | Fluconazole 100 mg/d | No relapse |
| 14 | 45 | M | Ghana | Fever, weight loss, splenomegaly | 24 | Blood | – | AmB 0.7 mg/kg/d | Death |
| 15 | 37 | M | DRC | Fever, lymph nodes | 100 | Lymph nodes | – | Itr 400 mg/d | Death |
| 16 | 41 | M | DRC | Lymph nodes, skin lesions | 50 | Lymph nodes | Lymph nodes | Liposomal AmB, Itr 400 mg/d | No relapse |
| 17 | 2 | F | DRC | Fever, skin lesions, bone lesions, blood | 45 | Skin, bone, blood | Skin | Liposomal AmB, fluconazole | No relapse |
*NR, not reported; AmB, amphotericin B deoxycholate; Itr, itraconazole; DRC, Democratic Republic of Congo; ABLC, amphotericin B lipid complex.
†Cases 1–14 are from the literature review; cases 15–17 are personal cases; see text.
