Nestor Pakasa, Asaf Biber, Samuel Nsiangana, Désiré Imposo, Ernest Sumaili, Hypolite Muhindo, Maria J. Buitrago, Iris Barshack, Eli Schwartz

Infection with the fungus Histoplasma capsulatum var. duboisii, also known as African histoplasmosis, was described
by Dubois et al. in 1952 (1). In total, <300 cases have been reported in the literature in Africa, mostly in sporadic
forms (2,3).
Although the classical histoplasmosis, caused by H. capsulatum var. capsulatum, involves mainly the lungs, African histoplasmosis commonly involves the skin, followed
by the bones. It tends to occur more frequently in patients infected with HIV. The pathogenesis of classical histoplasmosis, inhaling spores from bats’ and birds’ soil or guano, is well established, but the pathogenesis of African histoplasmosis remains unclear (2).
In the past, few reported cases of African histoplasmosis
have been described from the Democratic Republic of the Congo; all were sporadic (3–6). We describe an unusual case series of African histoplasmosis in HIV-negative patients
in Kimpese, Democratic Republic of the Congo.

Emerging Infectious Diseases • •Vol. 24, No. 11, November 2018