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Ileal perforation secondary to histoplasmosis in AIDS

M T Flannery1, V Chapman, I Cruz-Gonzales

  • 1Department of Internal Medicine, University of South Florida College of Medicine, Tampa, USA. mflann5555@aol.com

The American Journal of the Medical Sciences
|January 10, 2001
PubMed

Insights

This case study highlights a rare presentation of disseminated histoplasmosis in an AIDS patient, causing gastrointestinal perforations. Early diagnosis and treatment are crucial for managing this opportunistic infection.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Immunocompromised Hosts

Background:

  • Disseminated histoplasmosis is a serious opportunistic infection, particularly in patients with advanced Human Immunodeficiency Virus (HIV) infection.
  • Gastrointestinal involvement is a common manifestation of disseminated histoplasmosis but can present atypically.
  • Ileal perforations are a rare but life-threatening complication.

Observation:

  • The patient presented with classic symptoms including abdominal pain, weight loss, fever, oral thrush, and pelvic inflammatory disease.
  • Radiographic imaging revealed a small bowel obstruction with evidence of free air, indicating a perforation.
  • Exploratory laparotomy confirmed two perforations in the distal ileum.

Findings:

  • Pathological examination of the ileal perforations demonstrated fungal elements consistent with Histoplasma capsulatum.
  • This case underscores the potential for severe gastrointestinal complications from histoplasmosis in the context of AIDS.

Implications:

  • Early recognition and diagnosis of gastrointestinal histoplasmosis are crucial for timely and effective treatment in AIDS patients.
  • This case highlights the importance of considering opportunistic infections like histoplasmosis in the differential diagnosis of abdominal emergencies in immunocompromised individuals.
  • Effective management of disseminated histoplasmosis in AIDS requires a multidisciplinary approach involving infectious disease specialists and surgeons.

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