Disseminated African Histoplasmosis in an Immunocompetent Patient in Morocco: A Case Report

Abstract

Histoplasmosis, caused by the fungus Histoplasma capsulatum, presents in two varieties: American histoplasmosis and African histoplasmosis. We report an unusual presentation of disseminated histoplasmosis in a 22-year-old immunocompetent African patient residing in Morocco, a non-endemic country. The patient was originally from Togo (the town of Kara), which he had not visited for three years. Symptoms included a diffuse rash, coxalgia, and hepatosplenomegaly. The patient likely experienced endogenous reactivation of a latent infection acquired in Togo where histoplasmosis is endemic. Diagnosis involved a skin biopsy revealing Histoplasma capsulatum, and treatment with oral itraconazole showed positive outcomes. Unlike American histoplasmosis, the association of African histoplasmosis with HIV is undetermined. The article underscores the importance of considering histoplasmosis in diverse clinical presentations, even in non-endemic regions, emphasizing early diagnosis and appropriate treatment for improved outcomes.