An unusual cutaneous tumor: African histoplasmosis following mudbaths: case report and review

Abstract

African histoplasmosis, caused by Histoplasma capsulatum var. duboisii, is endemic in Africa. The disease usually involves the skin, subcutaneous tissue, and bones. A case of African histoplasmosis presenting as a cutaneous tumor and non-healing wound in a 66-year-old immunocompetent male residing in Africa, the first ever reported following mudbaths and acupuncture, is hereby reported. Diagnosis was confirmed by means of polymerase chain reaction performed on tissue material. The patient was started on long-term itraconazole therapy and he responded well. African histoplasmosis should be included in the differential diagnosis of non-healing wounds or tumor-like lesions, especially in the context of mudbaths in an endemic area.

Figure 1.

Skin lesion at the time of the initial evaluation.

Figure 2.

Overview of the ulcerated cutaneous tumor (A, Hematoxylin-Eosin,×4); fungi within giant cells, epidermis at upper right (B, Hematoxylin-Eosin, ×40); fungi highlighted by periodic acid Schiff (PAS) (C, ×40, arrow at budding form) and Grocott (D, ×40).