Disseminated histoplasmosis in an immunocompetent individual diagnosed with gastrointestinal endoscopy: a case report

Abstract

BackgroundHistoplasmosis is one of the invasive fungal infections and presents with symptoms mainly in the lungs. Disseminated histoplasmosis (DH) is rare and its lesions in the gastrointestinal tract are even uncommon. The concomitant involvement of the upper and lower gastrointestinal tract has never been described in the immunocompetent individuals.Case presentationA 44-year-old immunocompetent Chinese man presented with fever, hepatosplenomegaly, fungal esophagitis and protuberant lesions with central depression and erosion along the mucous membrane of the colon. The patient was diagnosed as disseminated histoplasmosis by gastrointestinal endoscopy.ConclusionsHistoplasmosis should be taken caution in patients with fever and hepatosplenomegaly. Actions should be taken to avoid its disseminated infection associated high mortality.

Disseminated Histoplasmosis in an Immunocompetent Patient After COVID-19 Pneumonia

“…Risk factors for most of the reported cases of disseminated histoplasmosis in immunocompetent patients include living in a rural setting due to the likely exposure to histoplasma in the soil [8]. Most of these patients experienced fever, weight loss, hepatosplenomegaly, lymphadenopathy, pancytopenia, elevated ESR, elevated hepatic transaminases, and had bone marrow involvement [8,9]. An immunocompromised state, including HIV/AIDS and chemotherapy-induced immunosuppression, is a known risk factor for disseminated histoplasmosis.…”

Intestinal histoplasmosis in immunocompetent patient: An unusual cause of massive small intestine bleeding

“…The most susceptible are patients with AIDS, HTLV-1 infection, hepatitis C infection, renal failure, glucocorticosteroid use and biological agents 9 , as well as methamphetamine use 10 . Disseminated disease in immunocompetent patients is found in < 0.05% 4 and only nine cases of GIH in immunocompetent patients have been reported 2 , probably due to an unknown defect in cell-mediated immunity 4 . Disseminated histoplasmosis is rare and lesions in the gastrointestinal tract are infrequent, manifesting as esophageal involvement in mediastinal adenitis, mediastinal fibrosis with esophageal involvement, and disseminated histoplasmosis with gastrointestinal involvement.…”

“…Gastrointestinal tract bleeding in patients with disseminated histoplasmosis and gastrointestinal involvement is unusual. The exact incidence of gastrointestinal histoplasmosis (GIH) is unknown because most patients remain asymptomatic 2 , only 3-12% of patients show symptoms 3 , it is reported in 70% of autopsies in immunosuppressed patients (HIV and transplant recipients) 2 and in immunocompetent hosts in only 0.05% of cases 4 . Histoplasmosis is also known as Darling's disease (1906), cave fever, or abandoned mine fever 5 .…”

Emerging Animal-Associated Fungal Diseases

“…Histoplasmosis is typically contracted by the inhalation of airborne conidia from the environment and usually affects AIDS patients. However, cases have recently been reported in otherwise immunocompetent individuals [ 68 , 84 , 85 ]. In general, histoplasmosis symptomatology ranges from asymptomatic in immunocompetent patients to fatal in immunocompromised ones [ 86 ].…”

“…The fungus once considered exclusively AIDS-related now shows association with other types of impairment of cellular immunity such as disorders related to mutation of the STAT-1 gene [ 107 , 108 ]. In Southern China and East India, immunocompetent individuals also seem to be involved [ 85 , 109 , 110 , 111 ].…”