Gastrointestinal Histoplasmosis as an Obstructing Ileocecal Mass

Nawaz, Zaid; Martín, S. Hernández; Reichstein, Ari R

doi:10.7759/cureus.12277

Cited by 5 publications

(12 citation statements)

References 12 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%

“…As a result of delay, some patients experienced worsening clinical states [ 33 , 69 , 89 , 105 , 107 , 116 ] and/or death [ 20 , 80 , 100 , 116 , 122 ]. A high index of suspicion in evaluating GIH in patients is needed as this will reduce the incidence of complications, such as lower gastrointestinal bleeding [ 17 , 26 , 27 , 29 , 30 , 31 , 33 , 39 , 44 , 53 , 56 , 59 , 63 , 70 , 84 , 94 , 102 , 103 , 105 , 110 , 119 ], intestinal perforation [ 54 , 73 , 80 , 111 ], ulceration [ 70 , 102 , 103 ], intestinal obstruction [ 15 , 21 , 50 , 57 , 81 , 89 , 95 , 102 , 103 , 104 , 117 ], acute pancreatitis [ 20 , 65 , 75 , 115 ], acute cholecystitis [ 44 , …”

Section: Discussionmentioning

confidence: 99%

“…Focusing on cases without HIV infection, the findings from our review suggest the need to also evaluate patients without HIV infection with risk factors for GIH including post-transplant patients on immunosuppressants [ 16 , 39 , 46 , 49 , 61 , 62 , 63 , 72 , 84 , 101 , 113 ], patients on immunosuppressants for other disease conditions [ 14 , 15 , 17 , 20 , 25 , 28 , 30 , 69 , 76 , 92 , 103 , 105 ] and patients with immunodeficiency syndrome [ 95 ] presenting with GI symptoms. This should be done regardless of the immune status of an individual as complications associated with GIH, such as acute abdomen [ 70 ], can also develop in immunocompetent patients.…”

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%

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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“…It can affect multiple organ systems such as the lungs, skin, central nervous system (CNS), liver, spleen, and the gastrointestinal (GI) tract; however, clinical manifestations vary depending on the immune status 1,8 . GI involvement is common, occurring in roughly 70–90% of cases with disseminated fungal infection, but only 3–12% of these patients are symptomatic 1,4,6,9,10 . Symptoms are nonspecific and include diarrhea, abdominal pain, fever, fatigue, weight loss, pancytopenia, and hepatosplenomegaly 4,6,8,11 .…”

Section: Discussionmentioning

confidence: 99%

“…4,9 Areas along the terminal ileum and ileocecal valve as well as in the colon are most commonly involved because of the abundance of lymphoid tissue. 1,4,10 GI bleeding and bowel obstruction generally occur as a result of enlarging lymphoid tissue and inflammatory masses that may mimic malignancy, occurring more in immunocompromised individuals. 9 Detection of histoplasmosis can be made by serological testing, immunofixation, PCR, and microscopy.…”

Section: Discussionmentioning

confidence: 99%

Disseminated histoplasmosis in an HIV/AIDS transgender male‐to‐female with atypical and persistent GI manifestations

Yee,

Huang,

Singh

et al. 2023

JGH Open

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Disseminated histoplasmosis is a rare complication of infection due to Histoplasma capsulatum. Typically, histoplasmosis is self‐limiting and asymptomatic in infected individuals with immunocompetence. Disseminated disease, however, can arise in high‐risk populations with primary or acquired cellular immunodeficiency including HIV/AIDS, transplant recipients, and those undergoing immunosuppressive therapy. Here we describe a unique case of extrapulmonary gastrointestinal histoplasmosis by infiltrative Peyer's patch disease with bone marrow involvement in a transgender HIV‐infected woman.

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Histoplasmosis peritonitis in an immunocompetent patient: case report

Jaugey,

Schneider,

Bellini

et al. 2024

BMC Infect Dis

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Histoplasmosis is a fungal infection most frequently seen in immunocompromised patients. It is endemic in Central and South America and in Africa. The infection is usually asymptomatic in a healthy individual. Extrapulmonary dissemination can be seen in immunocompromised hosts. Gastrointestinal manifestations frequently involve the terminal ileum and cecum, mimicking Crohn’s disease or malignancy. We describe the case of a 36-year-old healthy man from Cameroon, living in Switzerland for 13 years and without any medical nor surgical history, who presented peritonitis not responding to antibiotics. CT-scan showed bowel obstruction and signs of peritonitis. We opted for an explorative laparoscopy, which was converted to laparotomy with extensive adhesiolysis. Diagnostic of histoplasmosis was confirmed by histology and PCR analysis on biopsy. To our knowledge, this is the first described case of peritonitis as main outcome of a disseminated histoplasmosis involving the peritoneum in an immunocompetent patient.

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Gastrointestinal Histoplasmosis as an Obstructing Ileocecal Mass

Cited by 5 publications

References 12 publications

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Disseminated histoplasmosis in an HIV/AIDS transgender male‐to‐female with atypical and persistent GI manifestations

Histoplasmosis peritonitis in an immunocompetent patient: case report

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