Disseminated Histoplasmosis; A Threat in Advanced HIV Disease Population in Sub-Saharan Africa?

Background: Histoplasmosis is a neglected acquired immune deficiency syndrome (AIDS)-defining disease in sub-Saharan African countries, which commonly misdiagnosed as tuberculosis (TB) due to similar imagery and clinical features; patients usually receive presumptive anti-TB treatment that considered failure. Patients with advanced human immunodeficiency virus (HIV) (AHD), CD4<200/mm3 or World Health Organisation stage 3 4, develop disseminated histoplasmosis (DH) diagnosed at late post-mortem, owing poor suspicion, lack of rapid diagnosis tools offer accurate results, non-availability accessibility appropriate antifungal medications. We report 31 cases DH amongst AHD population from the literature, highlighting challenging care issue Africa.
 Results: Out reported 64.51% (20/31) were caused by Histoplasma capsulatum var capsulatum, 48.38% (15/31) being immigrants Europe, Canada Japan, 41.93% (13/31) mortality, 6 having no outcome. The index suspicion on part clinicians; skilled laboratory personnel for proper detection either classical coexisting many countries; medications most challenges caring HIV Conclusion: there need prompt routine screening Africa an AIDS-defining illness.