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Gastrointestinal histoplasmosis.

M S Cappell1, W Mandell, M M Grimes

  • 1Department of Medicine, Albert Einstein College of Medicine, New York, New York 10461.

Digestive Diseases and Sciences
|March 1, 1988
PubMed
Summary
This summary is machine-generated.

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Gastrointestinal histoplasmosis often presents as a mass or ulcers, mimicking other diseases in immunocompromised patients. Early diagnosis via endoscopy and biopsy is crucial for effective medical management.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Mycology

Background:

  • Gastrointestinal histoplasmosis is a rare manifestation of disseminated histoplasmosis.
  • It often affects immunocompromised individuals, including those with lymphoma or acquired immunodeficiency syndrome (AIDS).
  • Patients may have a history of travel to endemic areas or prior radiation therapy.

Observation:

  • Three cases presented with small-bowel obstruction, ileal and colonic involvement, and an exophytic rectal mass.
  • Symptoms often mimic inflammatory bowel disease or gastrointestinal carcinoma.
  • Pulmonary symptoms are uncommon, with gastrointestinal symptoms predominating.

Findings:

  • Gastrointestinal histoplasmosis represents a distinct clinical subset of disseminated disease.

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  • Lesions commonly appear as masses or ulcers, particularly in the terminal ileum.
  • The complement fixation test is positive in approximately 75% of tested cases.

    • Implications:

    • Immunocompromised patients with gastrointestinal symptoms suggestive of malignancy or IBD should be evaluated for histoplasmosis.
    • Endoscopic examination with biopsy, stains, and culture is recommended for diagnosis.
    • Medical management is the primary treatment, with surgery reserved for complications or diagnostic necessity.