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.

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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