Severe anal ulceration secondary to Histoplasma capsulatum in a patient with HIV disease

G B Winburn1, K A Yeh

  • 1Department of Surgery, Medical College of Georgia Hospital and Clinics, Augusta 30912-4000, USA.

The American Surgeon
|April 6, 1999
PubMed

Insights

Severe fungal infections like Histoplasma capsulatum are rising in immunocompromised patients, including those with acquired immunodeficiency syndrome (AIDS). This case highlights the critical role of surgeons in diagnosing and treating invasive anal Histoplasmosis.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Severe fungal infections are increasingly prevalent in immunocompromised individuals, particularly those with human immunodeficiency virus (HIV).
  • Histoplasma capsulatum is an opportunistic pathogen found in specific geographic regions, affecting a notable percentage of acquired immunodeficiency syndrome (AIDS) patients.

Observation:

  • Immunocompromised patients presenting with severe anal ulceration and suppuration require prompt surgical evaluation.
  • Such presentations necessitate comprehensive laboratory assessment for opportunistic infections.

Findings:

  • A case of invasive Histoplasma capsulatum infection of the anus is detailed.
  • The study outlines the natural history, clinical presentation, diagnostic methods, and treatment strategies for this condition.

Implications:

  • Surgeons are pivotal in the early diagnosis and management of invasive fungal infections in the anus.
  • Understanding the presentation and treatment of Histoplasma capsulatum is crucial for improving patient outcomes in endemic areas.

Related Concept Videos

Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Amebiasis01:28

Amebiasis

Entamoeba histolytica, a protozoan parasite, is responsible for intestinal and extraintestinal amebiasis. Though a significant proportion of infections remain asymptomatic, approximately 50 million individuals annually are estimated to present with clinical disease, resulting in up to 100,000 deaths globally. The disease burden is disproportionately high in regions with lower socioeconomic status, such as parts of India, Africa, Mexico, and Latin America.Etiology and TransmissionThe infective...
Peptic Ulcer01:27

Peptic Ulcer

Peptic ulcers are erosive lesions of the gastric or duodenal lining, most commonly caused by Helicobacter pylori infection. This Gram-negative, helical bacterium has adapted to survive the stomach’s acidic environment by producing urease, which converts urea into ammonia and carbon dioxide. The ammonia neutralizes gastric acid in the bacterium’s immediate environment, allowing colonization of the gastric mucosa. H. pylori attaches to mucus-secreting epithelial cells, penetrates the mucus...
Peptic Ulcer Disease II: Pathophysiology01:24

Peptic Ulcer Disease II: Pathophysiology

Peptic ulcer disease develops when protective mechanisms of the gastrointestinal mucosa are overwhelmed by harmful factors, leading to localized erosions in the stomach or proximal duodenum. The main causes are Helicobacter pylori infection and chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs).Helicobacter pylori–Induced InjuryBacterial Adaptation and Colonization:H. pylori is a spiral, Gram-negative bacterium adapted to the acidic stomach. and transmitted through oral-oral or...
Peptic Ulcer Disease II: Pathophysiology01:28

Peptic Ulcer Disease II: Pathophysiology

Peptic Ulcer Disease (PUD) is characterized by the development of ulcers in the stomach or duodenal mucosa. Its pathophysiology is complex, involving a balance between damaging and protective elements.
Damaging agents such as Helicobacter pylori, gastric acid, pepsin, and nonsteroidal anti-inflammatory drugs (NSAIDs) can weaken the mucosal defense, allowing hydrogen ions to infiltrate back and harm epithelial cells.
Peptic Ulcer Disease III: Clinical Manifestations and Complications01:25

Peptic Ulcer Disease III: Clinical Manifestations and Complications

Duodenal UlcersDuodenal ulcers are the most common form of peptic ulcer disease, presenting with chronic, intermittent epigastric pain. Pain typically appears 2–3 hours after meals, especially when the stomach is empty, often waking patients at night. It is characteristically relieved by food or antacids (“pain–food–relief”). Some patients remain asymptomatic until complications like bleeding or perforation emerge, particularly with NSAID or anticoagulant use.Gastric UlcersGastric ulcers share...