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Published on: May 2, 2018
Primary Histoplasma capsulatum Enterocolitis Mimicking Peptic and Inflammatory Bowel Disease
Rahman Nakshabendi1, Andrew C Berry2, Daisy Torres-Miranda3
1Division of Gastroenterology, University of Iowa, Iowa City, IA, USA.
Abstract:
In immunocompromised patients, histoplasmosis may present as disseminated disease. We present a 52-year-old Caucasian male with symptoms of dyspepsia, postprandial epigastric pain, nausea, and nonbloody diarrhea. Upper and lower gastrointestinal endoscopies were suspicious for inflammatory bowel disease (IBD); however, biopsies were consistent with histoplasmosis, specifically in the duodenum.
Insights
Disseminated histoplasmosis can affect immunocompromised patients. This case highlights duodenal histoplasmosis mimicking inflammatory bowel disease (IBD) in a 52-year-old male.
Area of Science:
- Medical Mycology
- Gastroenterology
- Immunocompromised Host Research
Background:
- Histoplasmosis is a fungal infection that can disseminate in immunocompromised individuals.
- Gastrointestinal symptoms like dyspepsia and diarrhea can be presenting signs of disseminated histoplasmosis.
- Distinguishing fungal infections from other gastrointestinal conditions, such as inflammatory bowel disease (IBD), can be challenging.
Purpose of the Study:
- To report a case of disseminated histoplasmosis presenting with gastrointestinal symptoms.
- To emphasize the importance of considering fungal infections in the differential diagnosis of IBD-like presentations in immunocompromised patients.
- To highlight the duodenal involvement in a rare case of histoplasmosis.
Main Methods:
- Case report of a 52-year-old Caucasian male.
- Clinical presentation including dyspepsia, epigastric pain, nausea, and diarrhea.
- Diagnostic procedures including upper and lower gastrointestinal endoscopies with biopsies.
Main Results:
- Endoscopic findings were initially suggestive of inflammatory bowel disease (IBD).
- Histopathological examination of duodenal biopsies confirmed the presence of histoplasmosis.
- The patient's symptoms were attributed to disseminated fungal infection.
Conclusions:
- Histoplasmosis can present atypically in the gastrointestinal tract, mimicking other conditions like IBD.
- Biopsy-proven diagnosis is crucial for identifying disseminated histoplasmosis in immunocompromised patients.
- Early recognition and treatment of histoplasmosis are essential to prevent severe complications.
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