A case report of gastrointestinal histoplasmosis in a patient treated with infliximab

Oliveras, Berta; Albert, Marc; López, Carme; Fort, Esther; Gutiérrez, Laia; Busquets, David; Uchima, Hugo; Aldeguer, Xavier; Piñol, Virgı́nia

doi:10.1007/s12328-020-01298-y

Cited by 4 publications

(11 citation statements)

References 11 publications

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“…Analysis of the 123 well-documented cases showed the clinical presentation of GIH was often non-specific and mimicked several other gastrointestinal conditions and pathologies, including abdominal tuberculosis (n = 3, 2.4%) [ 85 , 96 , 102 ], GIH and TB coinfection was reported in four [3.3%] cases [ 78 , 87 , 96 , 98 ], inflammatory bowel disease (n = 9, 7.3%) [ 21 , 33 , 40 , 52 , 69 , 75 , 89 , 105 , 107 ], intestinal obstruction (n = 15, 12.2%) [ 15 , 21 , 39 , 50 , 57 , 64 , 71 , 77 , 81 , 89 , 95 , 102 , 103 , 104 , 117 ], abdominal malignancy (n = 9, 7.3%) [ 14 , 16 , 31 , 80 , 83 , 101 , 102 , 108 , 112 ], GI bleeding (n = 29, 23.6%) [ 17 , 18 , 25 , 26 , 27 , 29 , 30 , 31 , 33 , 37 , 41 , 44 , 53 , 56 ,…”

Section: Resultsmentioning

confidence: 99%

“…The non-specific signs and symptoms of GIH, as highlighted in this review, include but are not limited to abdominal pain [ 12 , 18 , 19 , 20 , 20 , 21 , 22 , 25 , 27 , 31 , 33 , 35 , 36 , 37 , 38 , 40 , 41 , 43 , 45 , 47 , 50 , 51 , 54 ], diarrhoea [ 12 , 17 , 19 , 21 , 22 , 36 , 37 , 38 , 39 , 40 , 43 , 53 , 68 , 74 , 75 , 103 , 104 , 105 , 106 ], fever [ 12 , 13 , 17 , 19 , 26 , 27 , 28 , 30 , 31 , 33 , 35 ], weight loss [ 13 , 31 , 77 , 79 , 84 , …”

Section: Discussionmentioning

confidence: 99%

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Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Ekeng

Itam-Eyo

Osaigbovo

et al. 2023

Life

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Gastrointestinal histoplasmosis (GIH) is infrequently described in people without underlying HIV infection. We aimed to compare the clinical presentation of GIH in people with and without HIV infection. We conducted a literature search of published cases of GIH from 2001–2021 and found 212 cases. Of these, 142 (67.0%) were male, and 124 (58.5%) had HIV infection. Most cases were from North America (n = 88, 41.5%) and South America (n = 79, 37.3%). Of the 212 cases, 123 (58.0%) were included in both clinical and pathological analyses. The remainder were excluded as details about clinical and pathological findings were not available. Of the 123 cases, 41 had HIV infection while 82 were without HIV infection. The diagnosis was predominantly by histopathology (n = 109, 88.6%). A significant proportion of people with HIV infection had abdominal pain as the most predominant symptom of GIH compared to those without HIV infection (65.9% versus 41.9%, p < 0.05). The colon was the most affected site with a slightly higher proportion in those with HIV infection compared with cases without HIV infection (46.3% versus 42.7%). The commonest pathologic findings were caecal and ileal ulcers. Caecal ulcers were significantly more frequent in cases with HIV infection compared to those without HIV (32.1% versus 7.1%, p < 0.05). Despite being more common in people with HIV infection, GIH also affects people without HIV infection with similar clinical presentations.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Ekeng

Itam-Eyo

Osaigbovo

et al. 2023

Life

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“…Cutaneous localisations of Histoplasma spp. were reported in nine patients (32.1%) [63,70,73,75,81,83,85,93], presenting as cellulitis [70,92], a solitary nodule [73], or widespread skin lesions [40,63,75,81,82,84]. A majority of cases were diagnosed by means of histology (22, 78.6%) associated with cultures (13, 46.4%) or PCR (10, 35.7%); in two patients, the diagnosis was confirmed by a post mortem examination [20,89].…”

Section: Patients With Other Immunocompromising Conditions (Oic)mentioning

confidence: 99%

“…A majority of cases were diagnosed by means of histology (22, 78.6%) associated with cultures (13, 46.4%) or PCR (10, 35.7%); in two patients, the diagnosis was confirmed by a post mortem examination [20,89]. The use of PCR was reported in 11 cases [44,71,76,84,86,88,[90][91][92][93][94]. Two cases were positive for urinary Histoplasma antigen [74,75].…”

Section: Patients With Other Immunocompromising Conditions (Oic)mentioning

confidence: 99%

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Antinori

Giacomelli

Corbellino

et al. 2021

JoF

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Human histoplasmosis is a mycosis caused by two distinct varieties of a dimorphic fungus: Histoplasma capsulatum var. capsulatum and H. capsulatum var. duboisii. In Europe, it is usually imported by migrants and travellers, although there have been some autochthonous cases, especially in Italy; however, most European physicians are unfamiliar with its clinical and pathological picture, particularly among immunocompromised patients without HIV infection. This systematic review of all the cases of histoplasmosis reported in Europe and Israel between 2005 and 2020 identified 728 cases diagnosed in 17 European countries and Israel described in 133 articles. The vast majority were imported (mainly from Central and South America), but there were also seven autochthonous cases (six in Europe and one in Israel). The patients were prevalently males (60.4%), and their ages ranged from 2 to 86 years. The time between leaving an endemic region and the diagnosis of histoplasmosis varied from a few weeks to more than 40 years. Progressive disseminated histoplasmosis was the most frequent clinical picture among people living with HIV infection (89.5%) or a different immunocompromising condition (57.1%), but it was also recorded in 6.2% of immunocompetent patients. Twenty-eight cases were caused by Histoplasma duboisii. Immunocompromised patients without HIV infection had the worst outcomes, with a mortality rate of 32%.

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“…Furthermore, the patient developed immunocompromise shortly after administration of infliximab, a TNF-α antagonist for psoriasis treatment. Anti-TNF-α therapy seemed to be well tolerated in people living with HIV, 7 but infliximab could induce opportunistic infections, such as histoplasmosis, 8 Mycobacterium marinum infection 9 and Listeria monocytogenes meningitis. 10 Thus, infliximab administration might contribute to HIV activation and AIDS progression.…”

Section: Discussionmentioning

confidence: 99%

A human immunodeficiency virus-seronegative acquired immunodeficiency syndrome patient with opportunistic infections: A case report

Zhang

Wang

et al. 2022

Int J STD AIDS

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Background In rare cases, people living with chronic human immunodeficiency virus (HIV) infection do not develop antibodies despite demonstrable infection. Delayed or missed diagnosis of HIV infection leads to a lack of timely therapy, resulting in rapid disease progression with opportunistic infections or malignancies. Case Report A 44-year-old Chinese man presented with sore throat, oral leukoplakia, fever, dyspnoea and diffuse ground glass-like lesions in both lungs. Serum cytomegalovirus DNA was detectable, and CD4+ T-cell count was low. The patient was suspected of being a person living with HIV despite of the repeatedly negative HIV antibody tests using enzyme-linked immunsorbent assay and Western blot. Subsequently, high-plasma HIV RNA viral load was found on two repeated tests, while HIV DNA was also positive. Thus, the patient was confirmed as presenting with HIV-seronegative acquired immunodeficiency syndrome (AIDS). The symptoms improved in response to effective anti-fungal and anti-retroviral therapy after diagnosis. Conclusion This is the third reported case of an HIV-seronegative AIDS patient in China, which are also rarely reported globally. HIV nucleic acid testing is important to screen out HIV infection, especially in those who present with severe immunodeficiency but remain HIV serogenative.

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A case report of gastrointestinal histoplasmosis in a patient treated with infliximab

Cited by 4 publications

References 11 publications

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

A human immunodeficiency virus-seronegative acquired immunodeficiency syndrome patient with opportunistic infections: A case report

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