Table 6.
Histoplasmosis mimicking malignancies/nephritic syndrome/malarial splenomegaly syndrome.
| Sex/age/country | Clinical findings | HIV | Initial diagnosis | Diagnostic method/final diagnosis | Treatment/outcome | References |
|---|---|---|---|---|---|---|
| F/21 months/Kenya | Anorexia, abdominal swelling, and passing of black colored stools. Examination findings: pale, with hepatosplenomegaly | N | Malarial splenomegaly syndrome/visceral leishmaniasis | Bone marrow aspirate cytology/DH | Not revealed | Pamnani et al. 11 |
| M/9/Nigeria | Large, painful swelling on the middle half of the right clavicle. Radiograph: Bone destruction | N | Osteomyelitis/osteosarcoma | Biopsy of the swelling/African histoplasmosis | Not revealed | Khalil et al. 12 |
| F/13/Nigeria | Neck masses, generalized body swelling, reduction in urinary output. Examination findings: Patient was in respiratory distress, pale, generalized body swelling and generalized lymphadenopathy. Bp, 160/100 mm Hg, oxygen saturation <88%. Ascitic fluid cytology was negative for malignant cells. Mantoux test were negative. Abd. USS; bilateral nephritis | N | Nephritic syndrome secondary to a lymphoma/(HIV)-associated nephropathy/ disseminated tuberculosis. | Lymph node biopsy: H. capsulatum. | Blood pressure and control of edema which became refractory. She died on the 16th day of admission | Ubesie et al. 14 |
| M/12/Nigeria | Soft, tender, and no fluctuant swelling on the left side of the face adjacent to the mental region of the mandible. Radiographs showed diffuse osteolysis of the alveolus in the lower left premolar region. | N | Burkitt’s lymphoma. | Histology of biopsied specimen had the appearance of African histoplasmosis | Recovered with AmB therapy after Cyclo was discontinued | Mace 15 |
| M/13/Nigeria | Swelling involving the left supraorbital and mid-frontal region of the skull. Examination findings: firm and tender oval swelling, which measured about 6.5 cm by 2.5 cm and occupied the left supraorbital and midfrontal regions of the skull | N | Burkitt’s lymphoma/neuroblastoma with orbital secondaries/septicemia with abscess formation | Microscopic examination of biopsy material revealed numerous yeast typical of Histoplasma duboisii. | AmB therapy; Patient recovered | Shoroye and Oyedeji 16 |
AmB, amphotericin B; Cyclo, cyclophosphamide; DH, disseminated histoplasmosis; N, negative; P, positive.