Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo.
Research Center and Study of Infectious and Tropical Pathologies, Oyo, Republic of Congo.
PLoS Negl Trop Dis. 2021 May 6;15(5):e0009318. doi: 10.1371/journal.pntd.0009318. eCollection 2021 May.
The Republic of Congo (RoC) is one of the African countries with the most histoplasmosis cases reported. This review summarizes the current status regarding epidemiology, diagnostic tools, and treatment of histoplasmosis in the RoC. A computerized search was performed from online databases Medline, PubMed, HINARI, and Google Scholar to collect literature on histoplasmosis in the RoC. We found 57 cases of histoplasmosis diagnosed between 1954 and 2019, corresponding to an incidence rate of 1-3 cases each year without significant impact of the AIDS epidemic in the country. Of the 57 cases, 54 (94.7%) were cases of Histoplasma capsulatum var. duboisii (Hcd) infection, African histoplasmosis. Three cases (5.3%) of Histoplasma capsulatum var. capsulatum infection were recorded, but all were acquired outside in the RoC. The patients' ages ranged between 13 months to 60 years. An equal number of cases were observed in adults in the third or fourth decades (n = 14; 24.6%) and in children aged ≤15 years. Skin lesions (46.3%), lymph nodes (37%), and bone lesions (26%) were the most frequent clinical presentations. Most diagnoses were based on histopathology and distinctive large yeast forms seen in tissue. Amphotericin B (AmB) was first line therapy in 65% of the cases and itraconazole (25%) for maintenance therapy. The occurrence of African histoplasmosis in apparently normal children raises the possibility that African histoplasmosis is linked to environmental fungal exposure.
刚果共和国（刚果（布））是报告曲菌病病例最多的非洲国家之一。本综述总结了刚果（布）曲菌病的流行病学、诊断工具和治疗现状。通过计算机检索 Medline、PubMed、HINARI 和 Google Scholar 在线数据库，收集刚果（布）曲菌病的相关文献。我们共发现 1954 年至 2019 年间诊断的 57 例曲菌病，每年发病率为 1-3 例，该国艾滋病流行并未产生显著影响。在这 57 例病例中，54 例（94.7%）为杜波依斯荚膜组织胞浆菌（Hcd）感染，即非洲组织胞浆菌病。记录了 3 例（5.3%）荚膜组织胞浆菌感染病例，但均在刚果（布）境外获得。患者年龄在 13 个月至 60 岁之间。第三或第四个十年的成年患者和≤15 岁的儿童患者数量相等（n = 14；24.6%）。皮肤病变（46.3%）、淋巴结（37%）和骨骼病变（26%）是最常见的临床表现。大多数诊断基于组织病理学和组织中可见的独特大型酵母形态。两性霉素 B（AmB）在 65%的病例中为一线治疗药物，伊曲康唑（25%）用于维持治疗。在看似正常的儿童中发生非洲组织胞浆菌病，提示非洲组织胞浆菌病可能与环境真菌暴露有关。
