Department of Medicine, College of Medicine, University of Ibadan, Nigeria.
Department of Pathology, University College Hospital, Ibadan, Nigeria.
J Mycol Med. 2022 Aug;32(3):101271. doi: 10.1016/j.mycmed.2022.101271. Epub 2022 Mar 8.
Histoplasmosis in Africa is caused by Histoplasma capsulatum var duboisii (Hcd) and/or Histoplasma capsulatum var capsulatum (Hcc)[1]. It occurs predominantly in immunocompetent patients as localized disease and less commonly in HIV positive patients as disseminated disease [2]. The most significant risk factor for histoplasmosis in Africa is HIV [3]. Histoplasmosis is often mis-diagnosed and treated empirically as tuberculosis (TB) in HIV patients in TB endemic areas [2,3]. The advent of highly active antiretroviral therapy (HAART) has not been associated with a significant decline in the incidence of histoplasmosis globally thus underscoring the importance of diagnosing this treatable condition in endemic regions [4]. We report a case of disseminated histoplasmosis in an AIDS patient with good clinical response to antifungal therapy but failure of immune reconstititution with HAART.
非洲的组织胞浆菌病由杜波伊斯组织胞浆菌变种（Hcd）和/或荚膜组织胞浆菌变种（Hcc）引起[1]。它主要发生在免疫功能正常的患者中，表现为局限性疾病，在 HIV 阳性患者中较少见，表现为播散性疾病[2]。在非洲，组织胞浆菌病的最重要危险因素是 HIV[3]。在结核病流行地区的 HIV 患者中，组织胞浆菌病常被误诊并经验性地作为结核病（TB）治疗[2,3]。高效抗逆转录病毒疗法（HAART）的出现并未显著降低全球组织胞浆菌病的发病率，这突显了在流行地区诊断这种可治疗疾病的重要性[4]。我们报告了一例 AIDS 患者发生播散性组织胞浆菌病的病例，该患者对抗真菌治疗有良好的临床反应，但 HAART 未能重建免疫。
