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African histoplasmosis: a review.

H C Gugnani1, F Muotoe-Okafor

  • 1Department of Microbiology, University of Nigeria, Nsukka, Nigeria. misunn@aol.com

Revista Iberoamericana De Micologia
|November 13, 2004
PubMed
Summary

African histoplasmosis, a deep fungal infection, primarily affects skin and bones in Africa. Research is ongoing to understand its transmission, diagnosis, and develop specific serological tests for better treatment outcomes.

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Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Tropical Medicine

Background:

  • African histoplasmosis, caused by Histoplasma capsulatum var. duboisii, is endemic in Central and West Africa and Madagascar.
  • The disease typically manifests as granulomatous lesions in the skin, subcutaneous tissues, and bones, with rare involvement of internal organs.
  • The etiological agent's natural reservoir was recently identified in a Nigerian bat cave, with evidence suggesting frequent asymptomatic infections in nearby residents.

Purpose of the Study:

  • To review the current understanding of African histoplasmosis, including its epidemiology, clinical presentation, diagnosis, and treatment.
  • To highlight the need for improved diagnostic tools and increased global awareness of this mycosis.
  • To discuss the biochemical and immunological characteristics of Histoplasma capsulatum var. duboisii in relation to var. capsulatum.

Main Methods:

  • Review of existing literature on African histoplasmosis.
  • Analysis of Histoplasma capsulatum var. duboisii's cell wall composition and enzymatic activities.
  • Evaluation of current diagnostic methods and serological markers.

Main Results:

  • Histoplasma capsulatum var. duboisii shares some characteristics with var. capsulatum, including a common exoantigen and proteinase/collagenase activities.
  • The yeast form of var. duboisii contains an antigen found in serotype 1,4 of var. capsulatum.
  • A monoclonal antibody test exists for var. capsulatum but does not cross-react with var. duboisii, indicating a need for specific diagnostic tests.

Conclusions:

  • There is a significant need for the development of specific serological diagnostic methods for African histoplasmosis.
  • Increased international awareness regarding this deep mycosis is crucial.
  • Effective treatments include Amphotericin B and azole antifungals such as ketoconazole, itraconazole, and fluconazole.

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