Histoplamosis in an immunocompetent man returning from Brazil: A diagnostic challenge helped by 18 FDG PET CT

Clémentine Montagnac (1) , Carole Eldin (2) , Anais Thouret (1) , Stéphane Ranque (2) , Philippe Brouqui (3)

1 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
2 VITROME - Vecteurs - Infections tropicales et méditerranéennes
3 MEPHI - Microbes évolution phylogénie et infections

A 43-year-old French man presented with fever, arthralgia, headache, night sweats and dry cough, 3 weeks after returning from Brazil. Physical examination was normal. He reported a visit at the botanic garden of Rio de Janeiro during a 7-day-trip. Blood tests revealed lymphocytosis (5.28G/L), C-reactive protein at 50mg/L, and cholestatic hepatitis (ASAT 148UI/L, ALAT 319UI/L, gamma-GT: 523UI/L, alkaline phosphatase: 234UI/L). Microbiological investigations were negative for the following: blood cultures, malaria quick test, Legionella pneumophila, Streptococcus pneumonia antigenuria; serology for HIV, Histoplasma, Brucella, Leptospira, blood PCR for C. burnetii, Histoplasma, Leptospira, culture and PCR for Mycobacterium tuberculosis. Chest CT-Scan showed bilateral lower lobes pulmonary condensations, two upper left supracentimetric nodules, a right hilar lymphadenopathy and a minimal bilateral pleural effusion.

Mots clés: Histoplasma capsulatum; Brazil; Travel; Immunocompetent

Domaines: Bactériologie; Maladies infectieuses

Clémentine Montagnac, Carole Eldin, Anais Thouret, Stéphane Ranque, Philippe Brouqui. Histoplamosis in an immunocompetent man returning from Brazil: A diagnostic challenge helped by 18 FDG PET CT. Travel Medicine and Infectious Disease, 2019, 27, pp.136-138. ⟨10.1016/j.tmaid.2018.10.004⟩. ⟨hal-02006693⟩