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. 2023 Mar 22;23(1):95.
doi: 10.1186/s12890-023-02388-6.

Acute pulmonary histoplasmosis of immunocompetent subjects from Martinique, Guadeloupe and French Guiana: a case series

Moustapha Agossou  1 , Jean-Marie Turmel  2 , Aude Aline-Fardin  3 , Nicolas Venissac  4 , Nicole Desbois-Nogard  5
Affiliations

Acute pulmonary histoplasmosis of immunocompetent subjects from Martinique, Guadeloupe and French Guiana: a case series

Moustapha Agossou et al. BMC Pulm Med. .

Abstract

Introduction: Histoplasmosis is a fungal disease caused by Histoplasma capsulatum. Histoplasma capsulatum var capsulatum is found in Martinique. Cluster cases following working in deserted house, have been described in Martinique. Cases of acute pulmonary histoplasmosis have been described in immunosuppressed individuals, or in case of substantial exposure to reservoirs of Histoplasma capsulatum; however, cases of acute histoplasmosis are rare in immunocompetent individuals.

Cases series: We report a series of 4 cases of sporadic acute pulmonary histoplasmosis in immunocompetent subjects. Investigation revealed definite exposure in one patient and 3 cases with potential exposure. The diagnosis was microbiological and histological in 3 patients and histological in one patient. All subjects had positive serology to histoplasmosis. Pulmonary involvement was in the form of nodules and micronodules in 3 cases and ground glass lesions in one case. Patients were treated with itraconazole for 3 months and all had a favourable outcome.

Conclusion: We report a series of 4 cases of acute pulmonary histoplasmosis in immunocompetent individuals, occurring in a context where exposure was uncertain. This raises the problem of occult exposure in the Caribbean. Interventions to raise awareness and encourage caution are warranted targeting the population of the French West Indies and French Guiana.

Keywords: Acute histoplasmosis; Acute respiratory failure; Histoplasma capsulatum; Pulmonary histoplasmosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
a: initial chest CT scan of case 1 showing diffuse and sometimes confluent nodules and micronodules. b: suppurative circumscribed necrosis and giant and epitheloïd cell. c: Small yeasts in black on Grocott stain. d: 3-month follow-up CT scan of case 1 showing lung abnormalities improvement
Fig. 2
Fig. 2
a: Initial chest CT scan of case 2 showing diffuse ground glass lesions. b: 6-month follow-up CT scan showing improvement of ground glass lesions
Fig. 3
Fig. 3
a: Initial chest CT of case 3 showing bilateral pulmonary nodules. b: Picture show a giant cell. c: Small yeasts in pink on Periodic Acid Schiff stain. d: Control scan at 3 months with improvement of the pulmonary anomalies in case 3
Fig. 4
Fig. 4
a: Initial chest CT of case 4 showing pulmonary nodules and micronodules sometimes confluent. b: Microscopic examination (X100) of a Histoplasma capsulatum var. capsulatum with MGG coloration. c: Microscopic examination (X400) of a Histoplasma capsulatum var. capsulatum culture on Sabouraud's medium. d: CT scan at 6 months in case 4 showing slight improvement but persistence of nodular lung images despite clinical improvement
See this image and copyright information in PMC

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