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Neurochirurgie
Vol 47, N° 4  - août 2001
p. 431
Doi : NCHIR-09-2001-47-4-0028-3770-101019-ART5
Cas clinique

Spondylodiscite à histoplasma duboisii
À propos de deux observations et revue de la littérature
 

D. N'Dri Oka [1], G. Varlet [1], M. Kakou [1], Y. Zunon-Kipre [1], E. Broalet [1], V. Ba Zeze [1]
[1] Service de Neurochirurgie (P r Ba Zeze), CHU de Yopougon, 21 BP 632, Abidjan 21, Côte-d'Ivoire.

Abstract
Spondylodiscitis due to Histoplasma duboisii . Report of two cases and review of the literature

We report two cases of African histoplasmosis caused by Histoplasma duboisii located in the spine, on two Malian adults aged 40 and 47 years respectively. Clinical signs consisted of dorsal spinal syndrome in both cases and a paraplegia in one case.

Radiography and CT scan revealed a spondylodiscitis without any bone reconstruction in both cases and a prevertebral abscess in one case. Diagnosis was confirmed by mycological and pathological examinations of surgical specimen which revealed Histoplasma duboisii fungus. Medical treatment, after surgical repair, consisted in ketoconazola with positive results after 12 months.

This localisation is rare. It raises diagnosis problems with tuberculous spondylodiscitis because of their radio-clinical resemblance.

Abstract

Les auteurs rapportent 2 observations d'histoplasmose africaine à localisation rachidienne, chez deux adultes d'origine malienne âgés de 40 ans et 47 ans. La symptomatologie clinique était faite d'un syndrome rachidien dorsal dans les 2 cas et d'une paraplégie dans un cas. Le diagnostic a été confirmé par les examens mycologiques et histopathologiques des pièces opératoires qui ont mis en évidence des levures d' Histoplasma duboisii . Le traitement médical, après la chirurgie réparatrice, a reposé sur le kétoconazole avec une suite favorable au terme de 12 mois.

Cette localisation est rare et pose des problèmes diagnostiques avec le mal de Pott du fait de leur ressemblance radio-clinique.

Keywords: African histoplasmosis. , spondyloscitis. , Histoplasma duboisii . , ketoconazola.






© 2001 Elsevier Masson SAS. Tous droits réservés.
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