Only few studies of histoplasmosis in immunocompetent patients have been reported in French Guiana. Therefore, we conducted a detailed clinical description of hospitalized patients suffering from histoplasmosis among non-HIV patients.

A single-center retrospective study was conducted in Cayenne hospital between 2008 and 2022. Inclusion population was composed of HIV-seronegative hospitalized patients presenting a fluid sample and/or biopsy with positive mycology or histopathology result for histoplasmosis. Isolated positive serology or PCR were not included.

We included 31 (91%) adults and 3 (9%) children, with a sex ratio M:F of 1:2. The median age was higher in women than in men (70 versus 54 years). Respiratory samples constituted the majority of the performed examinations (38%). Fever (>37°C) was found in 56% of patients. Surprisingly, histoplasmosis was disseminated in 82% of patients with an overall case-fatality rate of 14.7%. However, immunosuppressive conditions were only found in 52% of adult patients, including lymphoid hemopathies, diabetes and immunosuppressive drugs.

This disease, even though rare and usually considered as a mostly benign disease in non-HIV patients, presented a relatively high mortality in our cohort. Thus, histoplasmosis should be suspected, screened and investigated as a first line of defense in highly endemic areas, even in immunocompetent and non-HIV patients, especially those with fever or chronic respiratory symptoms.