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African histoplasmosis (AH) is a fungal infection due to Histoplasma capsulatum var. duboisii. Unlike classic histoplasmosis, infections caused by H. duboisii most commonly affects the skin, subcutaneous tissues, lymph nodes and bones. Till present, in Europe, all published cases have been from natives from Africa who moved to Europe. There are few reports in the literature describing the radiologic features of AH. The authors report a case of a 7-year-old girl, from Guine-Bissau, who had multiple skin and subcutaneous lesions and left lower limb deformity. The presence of H. duboisii was confirmed by culture and histologic examination. Imaging studies were performed and showed multiple calcified and non-calcified subcutaneous lesions compatible with granulomas/abscesses; axillary and thoracic lymphadenopathies; and signs of chronic osteomyelitis. Although these imaging features are not pathognomic they should raise awareness for the diagnosis of AH in patients that are African or people who have travelled from this continent. Imaging plays a crucial role not only in the diagnosis of this disease but also in monitoring the response to therapy and detecting recurrence.