{"id":147,"date":"2025-08-01T22:10:26","date_gmt":"2025-08-01T22:10:26","guid":{"rendered":"https:\/\/dermacab.net\/?page_id=147"},"modified":"2025-08-02T21:18:22","modified_gmt":"2025-08-02T21:18:22","slug":"histoplasma-capsulatum-histoplasmose","status":"publish","type":"page","link":"https:\/\/dermacab.net\/index.php\/prise-en-charge-des-infections-sexuellement-transmissibles-ist\/ist-fongiques-ou-a-agents-opportunistes\/histoplasma-capsulatum-histoplasmose\/","title":{"rendered":"\ud83e\udda0 Histoplasma capsulatum \u2013 Histoplasmose"},"content":{"rendered":"\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\"><\/h2>\n\n\n\n<p><em>Mycose syst\u00e9mique end\u00e9mique, \u00e0 tropisme pulmonaire, cutan\u00e9 et g\u00e9nital chez l\u2019immunod\u00e9prim\u00e9<\/em><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83d\udccc <strong>Qu\u2019est-ce que l\u2019histoplasmose ?<\/strong><\/h3>\n\n\n\n<p>L\u2019histoplasmose est une <strong>infection fongique profonde<\/strong> caus\u00e9e par <em>Histoplasma capsulatum<\/em>, un <strong>champignon dimorphe<\/strong> pr\u00e9sent dans les sols riches en excr\u00e9ments d\u2019oiseaux ou de chauves-souris (grottes, pigeonniers, parcs).<br>Elle est <strong>end\u00e9mique en Am\u00e9rique du Nord, Afrique de l\u2019Ouest, Asie du Sud-Est<\/strong>, et signal\u00e9e sporadiquement au <strong>S\u00e9n\u00e9gal<\/strong>.<br>Chez l\u2019immunocomp\u00e9tent, elle est souvent <strong>asymptomatique<\/strong>, mais elle peut devenir <strong>grave ou diss\u00e9min\u00e9e<\/strong> chez les <strong>patients immunod\u00e9prim\u00e9s<\/strong> (VIH stade avanc\u00e9, transplantation, corticoth\u00e9rapie\u2026).<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Des <strong>localisations g\u00e9nitales, p\u00e9rianales ou cutan\u00e9o-muqueuses<\/strong> peuvent mimer des IST ou des cancers.<\/p>\n<\/blockquote>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83d\udd2c <strong>Mode de transmission<\/strong><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Inhalation<\/strong> de microconidies a\u00e9rosolis\u00e9es \u00e0 partir de terre contamin\u00e9e<\/li>\n\n\n\n<li>Pas de transmission interhumaine<\/li>\n\n\n\n<li>Atteinte g\u00e9nitale : <strong>par diss\u00e9mination h\u00e9matog\u00e8ne<\/strong>, secondaire \u00e0 la forme pulmonaire<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\u26a0\ufe0f <strong>Manifestations cliniques<\/strong><\/h3>\n\n\n\n<h4 class=\"wp-block-heading\">Forme pulmonaire :<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Fi\u00e8vre, toux s\u00e8che, douleurs thoraciques<\/li>\n\n\n\n<li>\u00c9panchement pleural, nodules, ad\u00e9nopathies hilaires<\/li>\n\n\n\n<li>Parfois image en cavit\u00e9 pseudotuberculeuse<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Forme diss\u00e9min\u00e9e (chez immunod\u00e9prim\u00e9s) :<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Fi\u00e8vre prolong\u00e9e, amaigrissement, sueurs nocturnes<\/strong><\/li>\n\n\n\n<li>Atteinte du foie, rate, moelle osseuse<\/li>\n\n\n\n<li><strong>Ulc\u00e9rations buccales, pharyng\u00e9es ou anog\u00e9nitales<\/strong><\/li>\n\n\n\n<li><strong>L\u00e9sions papulo-nodulaires, verruqueuses, ou ulc\u00e9r\u00e9es<\/strong> (peau, verge, vulve, anus)<\/li>\n<\/ul>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Les <strong>ulc\u00e9rations g\u00e9nitales chroniques<\/strong> peuvent \u00eatre <strong>confondues avec une syphilis, un carcinome, une tuberculose ou une gale hyperk\u00e9ratosique<\/strong>.<\/p>\n<\/blockquote>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83e\uddea <strong>Diagnostic<\/strong><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Biopsie cutan\u00e9e, g\u00e9nitale ou m\u00e9dullaire : levures intracellulaires (coloration PAS ou argentique)<\/li>\n\n\n\n<li>Culture fongique (2 \u00e0 4 semaines)<\/li>\n\n\n\n<li><strong>Antig\u00e9nurie Histoplasma<\/strong> (tr\u00e8s sensible dans les formes diss\u00e9min\u00e9es)<\/li>\n\n\n\n<li>S\u00e9rologies (IgG\/IgM) utiles en primo-infection<\/li>\n\n\n\n<li>PCR ou immunohistochimie selon disponibilit\u00e9<\/li>\n\n\n\n<li>Radiographie thoracique syst\u00e9matique<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83d\udc8a <strong>Traitement<\/strong><\/h3>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Antifongiques syst\u00e9miques de longue dur\u00e9e<\/p>\n<\/blockquote>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Forme l\u00e9g\u00e8re\/mod\u00e9r\u00e9e :<br>\ud83d\udc49 Antifongique pendant 6 \u00e0 12 mois<\/li>\n\n\n\n<li>Forme s\u00e9v\u00e8re ou diss\u00e9min\u00e9e :<br>\ud83d\udc49 <strong>Antifongique IV<\/strong>, puis relais PO<\/li>\n\n\n\n<li>Contr\u00f4le de la charge virale VIH ou r\u00e9duction de l\u2019immunosuppression<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83d\udee1\ufe0f <strong>Pr\u00e9vention<\/strong><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u00c9viter les lieux contamin\u00e9s par les fientes d\u2019oiseaux (grottes, fermes, chantiers)<\/li>\n\n\n\n<li>Port de masques filtrants en zone \u00e0 risque<\/li>\n\n\n\n<li>Surveillance \u00e9troite des personnes immunod\u00e9prim\u00e9es de retour de zones end\u00e9miques<\/li>\n\n\n\n<li>Aucun vaccin disponible<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83e\uddd1\ud83c\udffd\u200d\u2695\ufe0f <strong>Prise en charge au cabinet du Dr Hadi HAKIM<\/strong><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>D\u00e9pistage et orientation rapide devant toute <strong>ulc\u00e9ration g\u00e9nitale chronique suspecte<\/strong><\/li>\n\n\n\n<li>Pr\u00e9l\u00e8vement cutan\u00e9 ou muqueux pour examen mycologique et histopathologique<\/li>\n\n\n\n<li>Suivi coordonn\u00e9 avec infectiologie, anatomopathologie, m\u00e9decine interne<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83d\udcde <strong>Diagnostic diff\u00e9rentiel des ulc\u00e9rations g\u00e9nitales et buccales chroniques chez l\u2019immunod\u00e9prim\u00e9<\/strong><\/h3>\n\n\n\n<p>\ud83d\udcde <strong>+221 33 821 31 22<\/strong><br>\ud83d\udcac <strong>WhatsApp m\u00e9dical confidentiel<\/strong><br>\ud83d\udccd <em>Cabinet de Dermatologie \u2013 Dakar<\/em><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Mycose syst\u00e9mique end\u00e9mique, \u00e0 tropisme pulmonaire, cutan\u00e9 et g\u00e9nital chez l\u2019immunod\u00e9prim\u00e9 \ud83d\udccc Qu\u2019est-ce que l\u2019histoplasmose ? L\u2019histoplasmose est une infection fongique profonde caus\u00e9e par Histoplasma capsulatum, un champignon dimorphe pr\u00e9sent dans les sols riches en excr\u00e9ments d\u2019oiseaux ou de chauves-souris (grottes, pigeonniers, parcs).Elle est end\u00e9mique en Am\u00e9rique du Nord, Afrique de l\u2019Ouest, Asie du Sud-Est, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":220,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-147","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/pages\/147","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/comments?post=147"}],"version-history":[{"count":1,"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/pages\/147\/revisions"}],"predecessor-version":[{"id":148,"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/pages\/147\/revisions\/148"}],"up":[{"embeddable":true,"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/pages\/220"}],"wp:attachment":[{"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/media?parent=147"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}