Intra-abdominal abscess: A clinical manifestation of African histoplasmosis

African histoplasmosis is an endemic fungal, disease, caused by Histoplasma capsulatum var. duboisii. The disease is generally limited to tropical areas of the African continent, namely West and Central Africa. It usually manifests as a systemic fungal infection and, rarely, the initial infection occurs through skin inoculation. We describe the clinical case of a patient from Guinea-Bissau, an endemic area of the disease, currently residing in Portugal. The disease presented as an intra-abdominal abscess. Surgical treatment resulted in the formation of a cutaneous fistula with a purulent discharge whose examination permitted the diagnosis of histoplasmosis. Antifungal. drug therapy with amphotericin B and itraconazole was effective, with full recovery of the patient. It seems that the initial infection of this patient occurred through cicatricial lesions on the abdominal skin, associated with African tribal scarification rituals. (c) 2009 Elsevier Masson SAS. All rights reserved.