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African histoplasmosis
Other Resources UpToDate PubMed

African histoplasmosis

Contributors: Edith Lederman MD, Noah Craft MD, PhD
Other Resources UpToDate PubMed


African histoplasmosis (AH), also known as large form histoplasmosis, is a rare disease caused by infection with the thermally dimorphic fungus Histoplasma capsulatum var. duboisii. It is endemic to central and western Africa between the Sahara Desert and the Zambezi River.

Although it is believed to be acquired through inhalation, infection usually spares the lungs. Direct cutaneous infection is also possible. Typically, an infection will involve the skin, bones, or lymph nodes. Involvement of the gastrointestinal tract, lungs, and other mucosal surfaces is seen occasionally. Fever is sometimes associated. Skin lesions may spontaneously resolve.

Additionally, the chronic disseminated form may result in chronic fever, hematologic abnormalities, and multiorgan involvement of the liver, spleen, and kidneys. Miliary infiltrates can be seen on chest films late in the chronic form.

Exposures to soils from endemic areas are the only risk factor.

African histoplasmosis has been reported as an opportunistic infection associated with development of acquired immune deficiency syndrome (AIDS).


B39.5 – Histoplasmosis duboisii

78511005 – African histoplasmosis

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Differential Diagnosis & Pitfalls

  • Atypical mycobacterial infection
  • Sporotrichosis
  • Cutaneous leishmaniasis
  • Cutaneous tuberculosis
  • Cutaneous anthrax
  • Tularemia
  • Primary syphilis or Secondary syphilis
  • Cutaneous nocardiosis
  • Mycetoma
  • Cat-scratch disease
  • Cutaneous squamous cell carcinoma

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Last Updated:07/18/2023
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African histoplasmosis
A medical illustration showing key findings of African histoplasmosis : Fever, Bone pain, Lymphadenopathy, Lytic bone lesions, Umbilicated papules
Clinical image of African histoplasmosis - imageId=2200034. Click to open in gallery.  caption: 'Multiple pink papules of varying sizes, some crusted, on the ear, cheek, and neck.'
Multiple pink papules of varying sizes, some crusted, on the ear, cheek, and neck.
Copyright © 2024 VisualDx®. All rights reserved.