Gastrointestinal Histoplasmosis: A Descriptive Review, 2001-2021.

Area of Science:

• Infectious Diseases
• Gastroenterology
• Mycology

Background:

• Gastrointestinal histoplasmosis (GIH) is rarely documented in individuals without HIV infection.
• Understanding the clinical spectrum of GIH in diverse populations is crucial for timely diagnosis and treatment.

Purpose of the Study:

• To compare the clinical and pathological presentations of gastrointestinal histoplasmosis (GIH) in patients with and without HIV infection.
• To identify key differences and similarities in disease manifestation between these two groups.

Main Methods:

• A comprehensive literature search was conducted for published GIH cases between 2001 and 2021.
• Cases were analyzed for clinical symptoms, affected gastrointestinal sites, and pathological findings.
• A subset of 123 cases with available clinical and pathological data were compared between HIV-positive and HIV-negative groups.

Main Results:

• Abdominal pain was a more predominant symptom in HIV-positive patients (65.9%) compared to HIV-negative patients (41.9%).
• The colon was the most commonly affected site in both groups.
• Caecal ulcers were significantly more frequent in HIV-positive individuals (32.1%) than in HIV-negative individuals (7.1%).

Conclusions:

• Gastrointestinal histoplasmosis affects both HIV-positive and HIV-negative individuals.
• While GIH presentation is broadly similar, specific findings like caecal ulcers are more prevalent in HIV-positive patients.
• Further research may elucidate underlying mechanisms for these observed differences.