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February 20, 1981

African Histoplasmosis in the United States

Author Affiliations

From the Department of Dermatology, The Johns Hopkins University School of Medicine, Baltimore (Dr Shore); the Departments of Clinical Microbiology (Dr Waltersdorff), Family Health (Dr Edelstein), and Pathology (Dr Teske), Washington Adventist Hospital, Takoma Park, Md. Dr Edelstein is now with the University of Maryland, Baltimore.

JAMA. 1981;245(7):734. doi:10.1001/jama.1981.03310320056028

THE TERM "African histoplasmosis" refers to a distinct form of histoplasmosis caused by the organism Histoplasma capsulatum var duboisii. All cases have originated in equatorial Africa—even the few recognized outside the continent.1,2 We describe the occurrence of the disease in a US resident who had been in Africa six years earlier.

Report of a Case  A 34-year-old Maryland woman had a 3-mm recurrent, crusted, tender scalp papule that she had first noted six years earlier during pregnancy while living in Zaire. She suspected that trauma from a hairpin initiated the lesion.Scrapings of skin from the lesion yielded several white cottony colonies composed of hyphae and tuberculate macroaleuriospores. At 37 °C, the organism converted to a yeast, and a presumptive identification of Histoplasma sp was made.A biopsy specimen of the scalp lesion revealed foci of inflammatory cells within the dermis with giant cells and histiocytes predominating. Numerous thick-walled