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.
Origin : Publication funded by an institution