The genitourinary tract may rarely be affected in African histoplasmosis. It needs to be considered in the differential diagnosis of a penile ulcer in endemic regions. The authors are from University Teaching Hospital of Lome (Togo) and University Teaching Hospital of Treichville (Ivory Coast).
Species: Histoplasma capsulatum var duboisii
Risk factors:
(1) contact with soil in endemic region
(2) HIV infection
Clinical features:
(1) chronic painful penis ulcer
(2) regional lymph nodes may be enlarged
(3) if part of disseminated disease there may be hepatosplenomegaly, lymphadenopathy and multiple skin lesions on other parts of the body
A biopsy of the ulcer shows:
(1) granulomatous inflammation with lymphocytes, plasma cells and eosinophils
(2) special stains (PAS, GMS) may show small ovoid yeast forms
The diagnosis may be confirmed by culture, PCR or antigen testing.
Differential diagnosis:
(1) tuberculosis
(2) cancer
(3) cryptococcosis
(4) syphilis
To read more or access our algorithms and calculators, please log in or register.
