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Histoplasmosis, africanB39.5
DefinitionThis section has been translated automatically.
Rare form of histoplasmosis in Africa.
PathogenThis section has been translated automatically.
Histoplasma capsulatum var. duboisii
Occurrence/EpidemiologyThis section has been translated automatically.
Very rare and only sporadically in Europe. Prevalent in Madagascar and West and Central Africa.
EtiopathogenesisThis section has been translated automatically.
Entry portal not yet secured (percutaneous, inhalation).
Clinical featuresThis section has been translated automatically.
Superficial subcutaneous granulomas with abscesses. Infection of the lymph nodes with fistulization is the rule.
HistologyThis section has been translated automatically.
Large, yeast-like fungal cells in tissue, giant tissue reaction, multinucleated giant cells, contain up to 30 fungal cells.
Internal therapyThis section has been translated automatically.
Amphotericin B once/day 0.3-0.8 mg/kg bw i.v. for 6 weeks, creeping in at 0.25 mg/kg bw/day i.v.; if well tolerated, increase to the above dose as a continuous infusion over 4-6 hours. Side effects such as paresis, arachnoiditis or radiculitis can be alleviated by pre-injection of glucocorticoids. In mild forms of the disease, cotrimoxazole (e.g. Eusaprim forte) can also be given as a long-term therapy over 1 year. Ketoconazole (e.g. Nizoral) also seems to be effective.