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African histoplasmosis - masquerading as a malignant bone tumour
A L Akinyoola1, O Onayemi, O C Famurewa
1Department of Orthopaedic Surgery and Traumatology, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Tropical Doctor
|October 13, 2006
Summary
African histoplasmosis is a rare fungal infection presenting as bone lesions in immunocompetent individuals. This case highlights successful treatment of extensive clavicle and humerus destruction with ketoconazole.
Area of Science:
- Mycology
- Infectious Diseases
- Orthopedic Pathology
Background:
- African histoplasmosis is a systemic fungal infection caused by *Histoplasma capsulatum* var. *duboisii*.
- While typically seen in immunocompromised individuals, it can occur in immunocompetent hosts.
- Disseminated forms can affect bone, leading to destructive lesions.
Observation:
- A 23-year-old immunocompetent woman presented with fungating swellings of the left shoulder and elbow.
- Symptoms included fever, weight loss, and anemia over two months.
- Radiographs revealed lytic destruction of the left clavicle and humerus.
Findings:
- Histopathological examination of biopsy specimens confirmed African histoplasmosis.
- The patient's bone lesions showed significant destruction.
Implications:
- This case underscores that African histoplasmosis should be considered in the differential diagnosis of destructive bone lesions, even in immunocompetent patients.
- Prompt diagnosis and treatment with antifungal agents like ketoconazole can lead to complete resolution.
- Further research into the pathogenesis and optimal management of bone involvement in African histoplasmosis is warranted.
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