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Atypical Obstructive Pseudotumors in AIDS as the Initial Manifestation of Gastrointestinal Histoplasmosis
Alejandro Hallo1, Malena Camacho2, Alejandra Rojas3
1Internal Medicine, Hospital de Especialidad Eugenio Espejo, Quito, ECU.
Abstract:
Histoplasma capsulatum is a dysmorphic fungus distributed worldwide commonly associated with pulmonary histoplasmosis. We report the case of an unusual presentation of gastrointestinal histoplasmosis leading to the obstruction of the intestinal lumen in a 30-year-old female, HIV positive, admitted to the hospital due to chronic abdominal pain and constipation. An initial abdominal CT revealed a mass in the sigmoid colon. A further colonoscopy showed an infiltrating, friable mass obstructing 80% of the lumen staining positive for H. capsulatum. The unspecific nature of the patient's symptoms along with the unusual presentation of the infection raises awareness about the importance of including new pathologies to differential diagnoses when treating AIDS patients.
Insights
This case report details an unusual gastrointestinal obstruction caused by Histoplasma capsulatum in an HIV-positive patient. It highlights the need to consider this fungal infection in AIDS patients with gastrointestinal symptoms.
Area of Science:
- Mycology
- Infectious Diseases
- Gastroenterology
Background:
- Histoplasma capsulatum commonly causes pulmonary infections.
- Gastrointestinal histoplasmosis is rare, particularly presenting as a bowel obstruction.
- Human Immunodeficiency Virus (HIV) infection increases susceptibility to opportunistic infections.
Observation:
- A 30-year-old HIV-positive female presented with chronic abdominal pain and constipation.
- Initial CT scan showed a sigmoid colon mass.
- Colonoscopy revealed an infiltrating, friable mass obstructing 80% of the lumen.
Findings:
- The mass stained positive for Histoplasma capsulatum.
- This represents an atypical presentation of gastrointestinal histoplasmosis.
- The patient's non-specific symptoms complicated the initial diagnosis.
Implications:
- Clinicians should consider gastrointestinal histoplasmosis in the differential diagnosis for AIDS patients with unexplained gastrointestinal issues.
- Early recognition and treatment are crucial to prevent complications like intestinal obstruction.
- This case underscores the importance of broadening diagnostic considerations in immunocompromised individuals.
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