Cranial and Spinal Locations of Histoplasma capsulatum ‎var. duboisii in Brazzaville‎

Background: Histoplasma capsulatum var. duboisii is a rare fungus, endemic in southern Africa of the Sahara and Madagascar.  Objective: To describe the confirmed cases of histoplasmosis. Methods: This retrospective study was conducted at the division of neurosurgery of Brazzaville academic hospital in the Republic of Congo. Clinical records of all confirmed cases who were admitted between January 2014 and December 2017 were reviewed. Results: A total of 5 confirmed histoplasmosis were admitted to the division of neurosurgery over a four year period. They were two women and three men, an average of 42 years of age, all immunocompetent. The radiological imaging identified two patients with the localized form of cold scalp abscess.  The other three, who were men, had disseminated forms.  Lung lesions for two patients with multi-staged spondylodiscitis and lung disease; and clavicular osteitis for the last patient. Four patients had received medical-surgical treatment. The last patient with clavicular osteitis had died before mycological findings.  Outcome was good for localized forms and unfavorable for disseminated forms. Conclusion: Infections with Histoplasma capsulatum var. duboisii are rare like in other studies, and thus diagnosed late.  The poor outcome could have been avoided through the biological examinations of any pathological material obtained on infectious lesions, because taken care of early, the results are satisfactory.