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The Radiology Corner. Gastrointestinal histoplasmosis, roentgenographic, clinical and pathological correlation
Abstract:
Five cases with gastrointestinal histoplasmosis are presented. Gastrointestinal involvement is moderately frequent during the hematogenous dissemination of histoplasmosis. Depending on the underlying pathological changes, six roentgenographic patterns can be identified: 1. malabsorptive; 2. ulcerative; 3. polypoid; 4. granulomatous; 5. tumefactive and 6. compressive. Perforation, hemorrhage, obstruction and erroneous diagnosis for ulcerative colitis, Crohn's disease or carcinoma are the major complications. Histoplasmosis should be included in the differential diagnosis of diseases presenting with a malabsorption pattern, gastrointestinal polyposis, ulcerative and granulomatous gastrointestinal diseases and carcinoma, particularly if pulmonary lesions co-exist.
Insights
Gastrointestinal histoplasmosis, a complication of disseminated histoplasmosis, presents with six distinct radiographic patterns. Early diagnosis is crucial to prevent complications like perforation and hemorrhage.
Area of Science:
- Medical Mycology
- Gastroenterology
- Radiology
Background:
- Gastrointestinal histoplasmosis is a recognized complication of disseminated histoplasmosis.
- Hematogenous spread of Histoplasma can lead to gastrointestinal tract involvement.
Purpose of the Study:
- To present five cases of gastrointestinal histoplasmosis.
- To describe the radiographic patterns associated with gastrointestinal histoplasmosis.
- To highlight potential complications and differential diagnoses.
Main Methods:
- Case series presentation.
- Review of radiographic findings in five patients with confirmed gastrointestinal histoplasmosis.
- Analysis of clinical presentations and outcomes.
Main Results:
- Six distinct roentgenographic patterns were identified: malabsorptive, ulcerative, polypoid, granulomatous, tumefactive, and compressive.
- Complications include perforation, hemorrhage, obstruction, and misdiagnosis as inflammatory bowel disease or carcinoma.
- Pulmonary lesions often co-exist with gastrointestinal involvement.
Conclusions:
- Gastrointestinal histoplasmosis requires consideration in the differential diagnosis of various gastrointestinal disorders.
- Radiographic pattern recognition aids in diagnosis.
- Prompt diagnosis and treatment are essential to manage complications.