Vitamin B12 is an essential micronutrient for optimal haemopoietic, neurocognitive, and cardiovascular function. Research findings have demonstrated that Vitamin B12 deficiency is prevalent among patients with Type 2 Diabetes Mellitus, but data are sparse in our setting. We evaluated serum vitamin B12 levels in patients with Type 2 diabetes mellitus and compared them with those of controls. This was a hospital-based comparative cross-sectional study conducted on 266 participants. One hundred and thirty-three patients with type 2 diabetes mellitus aged 30–70 years who met the study inclusion criteria were recruited by random sampling technique from the Endocrinology/Diabetes clinics of Alex Ekwueme Federal University Teaching Hospital, Abakaliki, after informed consent was obtained. Similarly, one hundred and thirty-three consenting, healthy non-diabetic subjects were also recruited as controls. The mean ages of the Type 2 diabetes mellitus patients and controls were 53.56 ± 10.16 and 50.73 ± 9.74, respectively. Notably, the study found a significant difference in the prevalence of vitamin B12 deficiency between the two groups: 31.6

Advanced HIV disease (AHD) is of great concern in developing countries like Nigeria. Nigeria implemented an AHD package of care that includes rapid qualitative point-of-care (POC) CD4 testing to identify individuals with CD4 counts ≤200 cells/mm3, guiding further screening (e.g. TB lipoarabinomannan and cryptococcal antigen tests). However, the accuracy of this qualitative method compared to gold-standard quantitative CD4 testing via flow cytometry remains uncertain. We aimed to evaluate the agreement between POC qualitative CD4 testing and gold standard for detecting CD4 counts ≤200 cells/mm3 Data were collected retrospectively from records of individuals who had been screened for an AHD clinical trial from February to November 2024 at antiretroviral therapy (ART) clinics of 7 tertiary hospitals across 5 geo-political zones in Nigeria. Persons newly found to have acquired HIV or had interrupted treatment for at least 6 months were screened with a rapid POC qualitative CD4 assay as standard of care. Those with CD4 count ≤200 cells/mm3 according to the POC assay subsequently had quantitative CD4 testing as screening for the trial. A total of 430 participants with a mean age of 40.8 years (±13.9 SD) were enrolled. A slight majority were females, 226(52.6%), and the Lagos University Teaching Hospital had the most participants [206(47.9%)]. Thirteen participants also had tuberculosis, while 1 each was found to have Hepatitis B and cryptococcal meningitis respectively. The qualitative POC CD4 method correctly identified 336(78.1%) out of 430 participants as having CD4 ≤200 cells/mm3 while misclassifying 94 out of 430 participants that actually had CD4 >200 cells/mm3 based on the gold standard. The qualitative POC CD4 method provides a rapid and cost-effective alternative to the gold standard but shows limitations, particularly near critical thresholds (≤200 cells/mm3). These limitations may impact clinical decisions and outcomes, suggesting the need for confirmatory quantitative testing where feasible. Rapid qualitative methods should complement, not replace, quantitative CD4 testing, especially in resource-limited settings where accurate risk stratification for treatment decisions are critical. All Authors: No reported disclosures

The need for antimicrobial stewardship in managing infectious conditions cannot be overemphasized, as it is vital to curbing antimicrobial resistance. Empyema thoracis is commonly encountered in the Nigerian setting. Still, data describing the spectrum of pathogens is sparse in the literature and further complicated by the lack of studies stating the antimicrobial susceptibility profile of pathogens. Over the past two decades, we identified only four observational studies and eight individual cases highlighting the microbial agents associated with empyema thoracis. Of the four studies, three stated the predominance of Gram-positive pathogens such as Streptococcus pneumoniae and Staphylococcus aureus. On the contrary, one study reported the emergence of Gram-negative pathogens such as Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Mycobacterium tuberculosis was implicated in two studies, and fungal pathogens, Candida and Histoplasma, in one study, despite studies from other regions showing fungal pathogens are amply involved in the causation of empyema thoracis. Of the four studies, only one demonstrated the antimicrobial susceptibility profiles of the associated pathogens and highlighted their resistance to commonly prescribed antibiotics. There is an urgent need to prioritise studies to understand the microbial profile of empyema thoracis in our setting and, more importantly, to identify the resistance profile of these pathogens, thereby averting inappropriate antibiotic use and enhancing effective antibiotic treatment.

Reviews describing the occurrence of aspergillosis in newborns are sparse in the literature and mostly fragmented as case reports despite being a significant health challenge in this at-risk group. A review published in 1998 identified 44 cases, and to date, there is no comprehensive study highlighting the burden of Aspergillus infection in this vulnerable group across the globe. We aimed to highlight the burden of Aspergillus infection in neonates, the spectrum of clinical presentation and treatment outcomes. We conducted a systematic literature search of the PubMed database from 1997 to December 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guideline and adhered to the PRISMA checklist to identify articles reporting Aspergillus infection in neonates. The search terms were (Aspergillus OR Aspergillosis) AND (newborn OR neonates). We identified 48 cases reported globally. Europe had the highest reported cases (n = 22, 45.8

Reviews highlighting the clinical and radiological mimicry between tuberculosis and invasive mycosis are frequent in the literature. In addition, there’s been some emphasis on the occurrence of invasive fungal diseases in previously treated tuberculosis patients. In contrast, data on concurrent tuberculosis and invasive fungal disease are sparse in the literature. This knowledge gap may drive a poor cognizance of such cases, hence the need for this review. We conducted a scoping review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines to identify cases of tuberculosis coexisting with invasive fungal disease reported worldwide. One hundred and fifteen cases were reported from Asia (n = 61, 53.0

Peripheral arterial disease is a major macrovascular complication of diabetes mellitus. We aimed to determine the prevalence of peripheral artery disease among patients with type 2 diabetes mellitus in Calabar and its correlation with traditional risk factors such as hypertension, dyslipidaemia, age, smoking, glycaemic control and inflammatory markers such as high-sensitivity C-reactive protein and fibrinogen. This was a hospital-based multi-centre cross-sectional comparative study. A proportionate stratified sampling technique was used to determine the number of diabetics recruited from the diabetes centre of the University of Calabar Teaching Hospital, Nigerian Navy Reference Hospital and General Hospital Calabar. Peripheral artery disease was defined as ankle brachial index value of < 0.9 in at least one limb and was measured using a handheld Doppler (8 MHz Life Dop Summit device). The prevalence of peripheral artery disease using ABI < 0.9 in this study was 37.5

Background Data from studies evaluating lung functions in individuals exposed to fumes generated during the preparation of roasted food items is lacking in the Nigerian setting. We aimed to evaluate the ventilatory functions of participants with direct exposure to smoke from roasted food and compared the findings with their counterparts (controls). Methods We conducted a cross-sectional comparative study involving food vendors (cases) of smoked food and workers (controls) operating in the same vicinity but not directly exposed to the smoke. A spirometer was used to measure the forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR). Thereafter, the percentage predicted FEV1, FVC, and FEV1/FVC indices were used to determine ventilatory impairment in both cases and controls. Results A total of 600 participants were enrolled, of which half (50.0%) were cases while the remaining 50.0% were in the control group. Respiratory symptoms such as coughing and wheezing, and the duration of presentation were higher in cases compared with the controls, with a statistically significant difference; p = 0.003, p = 0.001 and p = 0.011, respectively. In addition, impaired ventilatory functions were significantly higher in the cases compared with the controls (p <0.001). Similarly, a significant proportion of the food vendors with ≥ 5 years of exposure had obstructive and mixed patterns of lung defects and a lesser proportion with normal lung functions compared with those with < 5 years of exposure (p = 0.009). Likewise, the mean FEV1 (p <0.001), FVC (p <0.001), and PEFR (p = 0.005) were significantly higher in controls compared with cases. Conclusion The direct exposure of food vendors to smoke may impair lung function. Driving awareness of this occupational hazard is very crucial as it is a common source of livelihood in the Nigerian setting.

Invasive aspergillosis is sparsely reported in patients with autoimmune diseases such as systemic lupus erythematosus, particularly in the Nigerian setting. Our case emphasizes the need to consider this seemingly rare presentation in immunocompromised Nigerian children. We report a known case of systemic lupus erythematosus with symptoms of high-grade continuous fever, progressive weight loss, generalized body weakness, and dull aching right hypochondrial pain of 2 months duration. No respiratory symptoms were present at presentation despite having an initial positive serum Aspergillus galactomannan titer of 9.6. She had persistent Plasmodium falciparum parasitemia and a full blood count showed neutrophilia. She was initially managed as a case of resistant malaria and sepsis with intravenous quinine and antibiotics, and subsequently discharged after resolution of symptoms. Three weeks later, she presented with worsening clinical signs of fever, hemoptysis, orthopnea, paroxysmal nocturnal dyspnea, and cyanosis. Chest X-ray showed focal nodules, haziness and areas of infiltration. A repeat assay of serum Aspergillus galactomannan level showed a markedly elevated titre of 21.5. A diagnosis of invasive pulmonary aspergillosis in an active systemic lupus erythematosus was made, and she was commenced on oral itraconazole and discharged after clinical resolution of presenting symptoms within a week of treatment. However, she again presented a week later with severe orthopnea, chest pains, delirious and tachypneic with tender hepatomegaly, and eventual demise within 6 h of presentation. Where an early laboratory evidence is available, we recommend initiating antifungal prophylaxis in patients with systemic lupus erythematosus flares regardless of the absence of symptoms suggesting an invasive fungal disease.

Pancytopenia in the setting of disseminated histoplasmosis is sparsely described in the literature. We investigated the underlying mechanisms of pancytopenia in disseminated histoplasmosis and highlighted clinical outcomes. We conducted a scoping review of cases and series on disseminated histoplasmosis presenting with pancytopenia published between 2001 and 2024. PubMed database was used for the search. The search terms were (disseminated histoplasmosis) AND (pancytopenia OR haemophagocytic syndrome OR lymphohistiocytosis). We identified 72 cases. Forty-four (61.1

Chronic pulmonary aspergillosis (CPA) is often misdiagnosed as tuberculosis (TB) in Nigeria, thus warranting unnecessary initiation of anti-Kochs treatment. Therefore, we must drive awareness of CPA in our setting to improve clinical outcomes and invariably reduce morbidities from this clinical entity. A 30-year-old man presented with symptoms of recurrent cough and difficulty in breathing for a 1-year duration. The patient was commenced on anti-tuberculosis medications despite having a negative GeneXpert result and had no improvement while receiving anti-TB treatment. Radiological findings from chest X-ray and chest CT scan also suggested a diagnosis of TB, and as such was initially considered as a case of pulmonary TB. However, the Aspergillus IgG assay returned positive and sputum culture yielded Aspergillus fumigatus and Aspergillus flavus which confirmed a diagnosis of CPA. Anti-Kochs regimen was discontinued and itraconazole commenced at 200 mg twice daily. The presenting symptoms resolved, and the patient was seen to have returned to a state of good health. A diagnosis of CPA should be considered in an unconfirmed TB patient, especially in a setting that is rife with TB. Training and retraining healthcare workers on the recognition of fungal diseases and the availability of fungal diagnostics would be invaluable in improving the diagnosis of CPA.

Invasive fungal infections (IFIs) are life-threatening affecting all age groups. Several studies on IFIs in Nigeria are documented, but reviews describing their occurrence in the paediatric population are lacking in the literature. We conducted a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Using the PubMed database, we identified case reports, series, and observational studies reporting IFIs in the Nigerian paediatric population from inception to December 2024. We identified a total of 114 cases of IFIs from 35 articles published between 1964 and 2023. Eight IFIs were identified including invasive candidiasis (59.6 %, n = 68), histoplasmosis (16.7 %, n = 19), pneumocystis pneumonia (2.6 %, n = 3), aspergillosis (2.6 %, n = 3), cryptococcosis (5.3 %, n = 6), entomophthoromycosis (7.9 %, n = 9), mucormycosis (2.6 %, n = 3) and eumycetoma (0.9 %, n = 1). Two (1.8 %) cases were reported as phycomycosis, and it was unclear whether these were cases of entomophthoromycosis or mucormycosis, as the fungal cultures were unsuccessful. Diagnosis was predominantly by culture (n = 59, 51.8 %) and histopathology (n = 30, 26.3 %). Outcomes were stated in 72 cases: 47 (41.2 %) recovered, 23 (20.2 %) died, one (0.9 %) lost to follow up and one (0.9 %) left against medical advice. Fatal outcomes were associated with delayed diagnosis and the lack of appropriate antifungals. IFIs are severely underdiagnosed in Nigerian children with significant gaps in the management of cases, including a low index of suspicion, delayed diagnosis, lack of diagnostics, especially the non-culture-based assays and poor accessibility to appropriate antifungal agents. Collaborative efforts to drive awareness and active surveillance of IFIs with funding for research targeted at the Nigerian paediatric population will mitigate these gaps.

The clinical presentation of histoplasmosis is non-specific and has several mimics as documented in the literature. Regarding cancers, previous reviews emphasized mainly the clinical and radiological similarities between histoplasmosis and pulmonary malignancies. Besides lung cancers, histoplasmosis also masquerades as other malignancies. We identified one hundred and twenty-four cases of histoplasmosis clinically mistaken for malignancies. Of the 124, 84 (67.7%) were included in the analyses of demographics, immune status, clinical features, diagnosis, and treatment outcomes. The remainder were excluded as the available data was mainly on diagnosis. Of the eighty-four, histoplasmosis was predominantly misdiagnosed as lung cancers (n = 16, 19.0%), gastrointestinal tumors (n = 15, 17.9%), and lymphomas/hematological malignancies (n = 15, 17.9%). Fifty-four (64.3%) were immunocompromised including 16 (29.6%) who were living with HIV, while the remainder were immunocompetent. We conclude that infective aetiologies like histoplasmosis should be considered or ruled out in patients clinically suspected of malignancy regardless of their immune status.

Disseminated histoplasmosis is rarely reported in patients living with cancers in Nigeria. We report a 40-year-old woman who presented with left neck swelling and abdominal pain of two weeks duration. Clinical examination and radiological findings showed pallor, epigastric tenderness, generalized lymphadenopathy and hepatosplenomegaly. An initial diagnosis of sepsis and micronutrient deficiency was made following findings of macrocytosis, hypersegmented neutrophils and toxic granulations on blood smear. Intervention with antibiotics did not improve symptoms rather her clinical presentation worsened with the onset of fever, dizziness, easy fatiguability and generalized weakness. Histology of lymph node biopsy reported a diffuse large B-cell lymphoma. A repeat examination of the blood smear revealed budding yeast cells morphologically similar to Histoplasma capsulatum. This case emphasizes the need for a high index of suspicion of histoplasmosis in this at-risk population and the usefulness of a blood smear in diagnosing histoplasmosis.

Background: Fungal contamination of hospital water distribution systems has been implicated in outbreaks of healthcare-associated infections. Objectives: To evaluate the prevalence of fungi in the water distribution system of a tertiary hospital in Nigeria. Design: This was a descriptive cross-sectional study. Methods: Swabs and water samples were collected from taps and faucets in the hospital categorized into low (Accidents and Emergency Unit, Children Emergency Unit, Acute Stroke Unit and the 24 in-patient hospital wards) and high-risk (Renal Dialysis Unit, Central Sterile Services Department, Theatres and Intensive Care Units (ICUs)) units based on the vulnerability of patients being managed there. The membrane filtration method for water analysis was used. Where possible, isolates cultured were identified to species level. In total, 105 water and 49 swab samples were collected for analysis. Results: All analysed water samples grew fungi. A total of 289 (high-risk; n = 178; low-risk; n = 111) and 76 fungi isolates were recorded from water and swab samples, respectively, with 31 different species identified. Aspergillus was the most predominant genus with five different species: Aspergillus niger (9.9%), terreus (4.4%), flavus (3.3%), fumigatus (8.8%) and versicolor (2.20%) isolated. Twenty-five and 18 species of fungi were identified in the low and high-risk units, respectively. The labour ward ( n = 46; 25.8%) and modular theatre ( n = 47; 42.3%) were the most contaminated units. Cladosporium spp. and Paecilomyces spp. were the most frequently isolated fungi in the low and high-risk units, respectively. The dialysis centre ( n = 9; 8.1%) and renal transplant theatre ( n = 7; 6.31%) had the lowest contamination rates in the high-risk units. Aspergillus niger , Cephalosporium curtipes , Penicillium chrysogenum and Penicillium glabrum were each identified in 4/6 units from which swabs were taken. The facility had no documented protocol for its water safety and quality. Conclusion: Our data reveal a high rate of contamination of hospital water sources by fungi, some of which are known to cause life-threatening infections. For better water treatment and water tank cleaning and disinfection, a standard protocol is advised. Ensuring that the water distribution systems in hospital settings are free of fungal contaminants is important to prevent the possibility of waterborne mycosis outbreaks.

Purpose of Review Onychomycosis is commonly reported in Africa, but data on its prevalence and spectrum of incriminated pathogens is fragmented in the literature. Understanding its epidemiology and profiling of the incriminated fungal pathogens would be very useful in managing patients as they are often difficult to treat, especially with the global emergence of antifungal resistance. Recent Findings We identified a total of 44 well-documented studies in 13 (24.1%) of the 54 African countries amounting to a total of 6773 cases of nail fungal infections: 4609 (68.0%) from North Africa, 1338 (19.6%) from West Africa, 524 (7.7%) from East Africa, 243 (3.6%) from Central Africa, and 59 (0.9%) from Southern Africa, with a pooled prevalence of 19.6% (6773/34604). Identification of fungal pathogens was mainly by conventional methods: microscopy ( n = 43, 97.7%), culture ( n = 42, 95.5%), and periodic acid-Schiff staining ( n = 1, 2.3%). Advanced diagnostics with improved sensitivity were also deployed in some studies: PCR ( n = 2, 4.5%), sequencing ( n = 2, 4.5%), and matrix-assisted laser desorption/ionization time of flight mass spectrometry ( n = 1, 2.3%). The most frequent fungal pathogens identified in North and Central Africa were Trichophyton rubrum (80.4% and 49.3%), followed by Candida albicans (12.2% and 27.4%), respectively, while in the West and East African regions, it was Candida albicans (63% and 47.3%) followed by Trichophyton rubrum (19.1% and 18.9%), respectively. Antifungal susceptibility testing was performed in only five studies and showed varied outcomes with high resistance of dermatophytes to ketoconazole, itraconazole, and fluconazole and non-dermatophyte moulds to caspofungin and 5-flucytosine, respectively. Summary Onychomycoses are frequent but of less cognizance as data was found from only 13 of the 54 African countries. The emergence of drug-resistant onychomycosis is of concern and informs the need to prioritize research in this area to improve diagnostics and the availability of antifungal susceptibility testing.

Understanding the interplay between infections and severe acute malnutrition is critical in attaining good clinical outcomes in managing malnourished children. However, review studies describing the profile of the associated pathogens in the malnourished African pediatric population are sparse in the literature. We aimed to identify the spectrum of pathogens from studies reporting infections in malnourished African children, as well as the antibiotic resistance pattern and clinical outcomes. A systematic literature of the PubMed database was conducted following PRISMA guidelines from January 2001 to June 2024. The search algorithm was ((marasmus) OR (kwashiorkor) OR (severe acute malnutrition) OR (protein energy malnutrition)) AND (Africa). For a more comprehensive retrieval, an additional search algorithm was deployed: (HIV OR tuberculosis) AND (severe acute malnutrition). We included 67 studies conducted between 2001 and 2024. Most of the studies were from East Africa (n=53, 79.1%) and Southern Africa (n=5, 7.4%). A total of 7,056 pathogens were identified comprising 3,030 Viruses, 2,381 bacteria, 1,452 parasites and 193 fungal pathogens. The predominant pathogens were HIV, Mycobacterium tuberculosis, and malaria parasites accounting for 42.5%, 25.2%, and 17.1% respectively. Antibiotic susceptibility testing was documented in only three studies. Fatality rates were reported in 49 studies and ranged from 2% to 56% regardless of the category of pathogen. This review affirms the deleterious effect of infections in malnourished patients and suggests a gross underdiagnosis as studies were found from only 17 (31.5%) African countries. Moreover, data on fungal infections in malnourished African children was nearly absent despite being at risk. There is also a need to prioritize research investigating African children with severe acute malnutrition for fungal infections besides other opportunistic pathogens and improve the availability of diagnostic tools and the optimized usage of antibiotics through the implementation of antimicrobial stewardship programmes.

Background: Deep mycoses are serious fungal diseases commonly associated with the immunocompromised but can also present in the immunocompetent following severe exposure to fungal pathogens. Included in this group are subcutaneous and systemic fungal infections. Objectives: Reviews highlighting skin involvement in patients with deep mycosis in the Nigerian setting are sparse in the literature. This systematic review summarized the clinical presentation, risk factors, and diagnosis of deep mycosis presenting with cutaneous manifestations in Nigerians. Design: This was a systematic review conducted following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Data sources and methods: PubMed, Google Scholar, and the African Journal Online database were searched from inception to February 2024 to identify published articles from Nigeria on deep mycoses with cutaneous manifestations. We included single case reports and case series on cutaneous involvement in deep fungal infections in Nigeria. Review articles, guidelines, meta-analyses, animal studies, and fungal studies not relating to the Nigerian setting were excluded. Results: We identified 16 well-documented articles on deep cutaneous mycoses published in Nigeria over the past six decades which amounted to 137 cases; 102 (74.5%) cases were reported before the year 2000, while the remainder were published within the past two decades. The 137 cases were majorly histoplasmosis ( n = 87, 63.5%) and eumycetoma ( n = 19, 13.9%) and predominant risk factors, farming ( n = 13, 9.5%) and diabetes mellitus ( n = 3, 2.2%), The diagnosis of cases was predominantly via histopathology ( n =131, 95.6%) with a few cases diagnosed by fungal culture ( n = 15, 10.9%), and antigen assay ( n = 1, 0.7%) respectively. Twenty-one (15.3%) were clinically diagnosed as cancers including a case of carcinoma of the skin, and one each (0.7%) as skin tuberculosis or neurofibromatosis but all histologically confirmed as deep cutaneous mycoses. Conclusion: The decline of reports on deep cutaneous mycoses in recent times suggests neglect or a low index of suspicion from attending clinicians. This is further buttressed in the misdiagnosis of cases as other clinical entities. Ensuring a histological diagnosis of skin lesions, especially in at-risk patients will mitigate these gaps.

Abstract Reports on cases of strongyloidiasis and tuberculosis or aspergillosis coinfection are fragmented in the literature and no large-scale reviews are describing its occurrence across the globe. We identified a total of 230 cases of strongyloidiasis and tuberculosis coinfection amongst 2376 participants with tuberculosis disease from eight epidemiological surveys conducted in Ethiopia (n = 4, 50%); Tanzania (n = 3, 37.5%) and Malaysia (n = 1, 12.5%). Clinical outcomes in these studies were not stated as they were largely descriptive. In addition, there were ten individual case reports of strongyloidiasis and tuberculosis coinfection. Of the ten, four were from the USA (40%), two each from India (20%) and Japan (20%), and one each from the UK (10%) and Argentina (10%). Of the ten, six had favourable outcomes, two were fatal and outcomes were unclear in the remainder. Ten cases of strongyloidiasis and aspergillosis coinfection were identified, five were reported from the USA (50%), and one each from the Netherlands (10%), China (10%), Iran (10%), Colombia (10%) and Italy (10%). Five each had favourable and fatal outcomes. Fatal outcomes in strongyloidiasis and tuberculosis or aspergillosis coinfection were associated with steroid therapy (n = 3), decline for treatment (n = 1), delayed diagnosis (n = 2) and delayed presentation (n = 1). Our findings suggest a significant proportion of individuals living with tuberculosis are also affected with strongyloidiasis, especially in sub-Saharan Africa. However, more studies are required to ascertain the burden of strongyloidiasis and tuberculosis coinfection as few cases were reported from other highly burdened tuberculosis regions. In addition, the role of the attending clinician is critical to reduce morbidities from the coexistence of these clinical entities as a significant number of cases with documented outcomes were fatal.

Although classified as an AIDS-defining illness, several reports show histoplasmosis also affects patients living with cancers including haematological malignancies and solid tumours. However, reviews describing cases of histoplasmosis in malignancies are lacking in the literature. We identified a total of thirty-four cases with twenty (58.8 %) cases reported from the USA, four from Brazil (11.8 %), three from India (8.8 %), and one each from Singapore (2.9 %), France (2.9 %), Netherlands (2.9 %), Colombia (2.9 %), Canada (2.9 %), Morocco (2.9 %), and Malaysia (2.9 %). 82.4 % (n = 28) of the cases were adults. Presenting symptoms were majorly fever (61.7 %), lymphadenopathy (50.0 %) and weight loss (29.4 %). Essential haematologic findings were pancytopaenia (n = 7, 20.6 %), neutropenia (n = 2, 5.9 %) and anaemia (n = 5, 14.7 %). The associated cancers were predominantly haematological and comprised 73.5 % (n = 25) of all cases. The diagnosis of histoplasmosis was via histopathology (n = 23, 67.6%), culture (n = 13, 38.2%), Histoplasma antigen assay (n = 13, 38.2%), anti-Histoplasma antibody assay (n = 5, 14.7%), PCR and sequencing (n = 2, 5.9%), peripheral blood film/direct microscopy (n = 4, 11.8%) and cytology (n = 1, 2.9%). Of the thirty-four cases, twenty-four (70.6%) had favourable outcomes, eight (23.5%) died, one (2.9%) was lost to follow-up and in one (2.9%) case, the outcome was not stated. Histoplasmosis is not an uncommon opportunistic disease complicating malignancies but is paradoxically underdiagnosed in Africa given the huge burden of cancers in that region. Besides following chemotherapy and the use of steroids, tumour necrosis factor-α antagonists therapy, hematopoietic stem cell transplantation and environmental exposure were factors associated with Histoplasma infection in patients with malignancies. A resolution to promptly screen suspected or confirmed cases of malignancies for histoplasmosis will improve diagnosis and clinical outcomes.