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

Abstract : 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.
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Submitted on : Wednesday, March 20, 2019 - 6:03:09 PM
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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, Elsevier, 2019, 27, pp.136-138. ⟨10.1016/j.tmaid.2018.10.004⟩. ⟨hal-02006693⟩

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