[Papular exanthema in systemic histoplasmosis and HIV infection]

Abstract

A 34-year-old HIV-infected African woman developed fever, weight loss and widespread papules on her trunk, arms and face. Skin biopsy and culture revealed histoplasmosis caused by Histoplasma capsulatum varietas capsulatum (American histoplasmosis). Even though antimycotic treatment and intensive care were started immediately the patient died because of the systemic mycosis within a few days. Histoplasmosis is a rare disease in Europe but endemic in some areas of the USA (e.g., Ohio, Mississippi) and of Africa. Additionally histoplasma capsulatum varietas duboisii is endemic in Central and South Africa.