[Colon and rectum histoplasmosis in a patient from Peru]

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pathology

Background:

• Histoplasmosis is a fungal infection typically affecting the lungs.
• Gastrointestinal involvement is more common in immunocompromised individuals.
• Colon and rectal histoplasmosis in immunocompetent patients is exceptionally rare.

Observation:

• A 52-year-old immunocompetent male presented with a 3-month history of rectal bleeding, tenesmus, weight loss, and perianal discharge.
• Colonoscopy revealed extensive ulcers throughout the colon and a 5 cm rectal lesion.
• Biopsies showed microorganisms within macrophages consistent with histoplasmosis.

Findings:

• Microscopic examination of biopsies confirmed histoplasmosis.
• ELISA tests for HIV and HTLV I-II were negative, indicating an immunocompetent status.
• The patient's symptoms and endoscopic findings were attributed to disseminated histoplasmosis.

Implications:

• This case highlights the possibility of gastrointestinal histoplasmosis in immunocompetent individuals.
• It underscores the importance of considering fungal infections in the differential diagnosis of unexplained gastrointestinal pathology.
• Further research is needed to understand the pathogenesis and management of histoplasmosis in immunocompetent hosts.