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Acute Colonic Perforation with Septic Shock Secondary to Disseminated Histoplasmosis in an Autologous Bone Marrow
Harsimrandeep Bhatti1, Enkhbileg Batbileg1, Srijisnu De1
1Department of Internal Medicine, Las Palmas Del Sol Medical Center, El Paso, TX, USA.
Abstract:
Histoplasma capsulatum is an opportunistic pathogen which can lead to a wide variety of clinical presentations in the immunocompromised host. Post-transplant histoplasmosis in hematopoietic cell transplant recipients is exceedingly rare, with an incidence of <1%. We present a case of acute caecal perforation resulting from disseminated histoplasmosis in a patient who had undergone autologous bone marrow transplant for plasma cell dyscrasia. This is a 71-year-old patient who initially presented due to progressive weakness associated with shortness of breath.
Insights
Disseminated histoplasmosis is a rare complication in hematopoietic cell transplant recipients. This case highlights acute caecal perforation as a severe manifestation in an immunocompromised patient.
Area of Science:
- Mycology
- Infectious Diseases
- Hematopoietic Stem Cell Transplantation
Background:
- Histoplasma capsulatum is an opportunistic fungal pathogen.
- Immunocompromised individuals are susceptible to disseminated infections.
- Post-transplant histoplasmosis is rare, affecting less than 1% of hematopoietic cell transplant recipients.
Observation:
- A 71-year-old patient presented with progressive weakness and shortness of breath.
- The patient had previously undergone autologous bone marrow transplant for plasma cell dyscrasia.
- The patient developed acute caecal perforation.
Findings:
- Disseminated histoplasmosis was diagnosed as the cause of caecal perforation.
- This represents an exceedingly rare presentation of post-transplant histoplasmosis.
Implications:
- This case underscores the importance of considering disseminated histoplasmosis in immunocompromised patients with unusual presentations.
- Early diagnosis and treatment are crucial for managing severe complications like gastrointestinal perforation.
- Further research into risk factors and management strategies for post-transplant histoplasmosis is warranted.
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