Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 7 , ISSUE 2 ( May-August, 2018 ) > List of Articles

CASE REPORT

Colonic Obstruction in an Immunosuppressed Patient with Gastrointestinal Histoplasmosis

Javier Perez-Calvo, Jordi Castellvi, Nuria Farreras, Lorenzo Viso, Patrizio Petrone

Keywords : Histoplasmosis, Abdominal location, Intestinal obstruction

Citation Information : Perez-Calvo J, Castellvi J, Farreras N, Viso L, Petrone P. Colonic Obstruction in an Immunosuppressed Patient with Gastrointestinal Histoplasmosis. Panam J Trauma Crit Care Emerg Surg 2018; 7 (2):167-169.

DOI: 10.5005/jp-journals-10030-1220

License: CC BY-NC 4.0

Published Online: 01-08-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Histoplasmosis is a systemic disease that usually affects immunosuppressed patients. Isolated intestinal manifestation is rare, and sometimes can be confused with other entities. A patient with acquired immunodeficienc syndrome (AIDS) delete hyphen associated with colonic obstruction due to intestinal histoplasmosis resolved with medical treatment is presented. Case report: A 35-year-old man arrived in the emergency room due to the intestinal occlusive syndrome. At a physical examination, a painful mass was detected at the right hypochondrium. He had been treated in another hospital for 11 months, but without recollection of his diagnosis. The Abdominal X-ray was compatible with intestinal occlusion, and the abdominal computed tomography (CT) showed a collapsed and stenotic lesion at the hepatic angle of the colon, with fistulous trajectories. A diagnosis of HIV was confirmed after contacting the previous hospital. The results of a recent colonoscopy described an ulcerated mass and a concentric stenosis in the transverse colon with a suspicious of malignancy. The biopsy confirmed Histoplasma capsulatum (H. capsulatum) by PCR. Because of these findings, medical treatment with antifungal and digestive exclusion was initiated, presenting good response without the need for more aggressive procedures. Conclusion: When immunodeficiency is diagnosed, especially HIV, and is associated with a not life-threating intestinal manifestation, a differential diagnosis must include opportunistic infections. Adequate medical treatment is usually sufficed to avoid unnecessary emergency surgical procedures.


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