Gastrointestinal Histoplasmosis Presenting as an Acute Abdomen with Jejunal Perforation
Introduction. Gastrointestinal histoplasmosis (GH) is a well-described albeit uncommon disease. It is found almost exclusively in the immunocompromised host, especially those with untreated HIV and low CD4 counts. Presentation with intestinal perforation is seen mostly commonly in the colon. We pres...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2018/8923972 |
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| author | Bryan R. Anderson Jaron Marriott Chinthaka Bulathsinghala Humayun Anjum Salim Surani |
| author_facet | Bryan R. Anderson Jaron Marriott Chinthaka Bulathsinghala Humayun Anjum Salim Surani |
| author_sort | Bryan R. Anderson |
| collection | DOAJ |
| description | Introduction. Gastrointestinal histoplasmosis (GH) is a well-described albeit uncommon disease. It is found almost exclusively in the immunocompromised host, especially those with untreated HIV and low CD4 counts. Presentation with intestinal perforation is seen mostly commonly in the colon. We present a patient with jejunal perforation, and there have been only 3 previous cases reported in the literature. Case. A 39-year-old male with known, untreated HIV presented to the ED with an acute abdomen after experiencing worsening intermittent abdominal pain for 2 months before that was associated with nausea, vomiting, diarrhea, and weight loss. CT of the abdomen and pelvis revealed evidence of gas in the mesentery, small bowel thickening, edema, and free fluid in the abdomen. Emergency exploratory laparotomy was conducted. Intraoperative findings included a perforated jejunum that was studded with nodular lesions as well as mesenteric masses. Histopathologic exam of these mesenteric masses and jejunal lesions were positive for histoplasmosis. Conclusion. Disseminated histoplasmosis is a life-threatening disease that occurs nearly exclusively in immunocompromised hosts. Untreated, mortality is as high as 80%. This rare presentation with jejunal perforation highlights the need for awareness of histoplasmosis involvement throughout the entirety of the GI tract. |
| format | Article |
| id | doaj-art-c232e5493ab14c64bb2c0f92e2cd1b9d |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
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| series | Case Reports in Medicine |
| spelling | doaj-art-c232e5493ab14c64bb2c0f92e2cd1b9d2025-02-03T05:59:22ZengWileyCase Reports in Medicine1687-96271687-96352018-01-01201810.1155/2018/89239728923972Gastrointestinal Histoplasmosis Presenting as an Acute Abdomen with Jejunal PerforationBryan R. Anderson0Jaron Marriott1Chinthaka Bulathsinghala2Humayun Anjum3Salim Surani4Bay Area Medical Center, Corpus Christi, TX, USABay Area Medical Center, Corpus Christi, TX, USABay Area Medical Center, Corpus Christi, TX, USABay Area Medical Center, Corpus Christi, TX, USABay Area Medical Center, Corpus Christi, TX, USAIntroduction. Gastrointestinal histoplasmosis (GH) is a well-described albeit uncommon disease. It is found almost exclusively in the immunocompromised host, especially those with untreated HIV and low CD4 counts. Presentation with intestinal perforation is seen mostly commonly in the colon. We present a patient with jejunal perforation, and there have been only 3 previous cases reported in the literature. Case. A 39-year-old male with known, untreated HIV presented to the ED with an acute abdomen after experiencing worsening intermittent abdominal pain for 2 months before that was associated with nausea, vomiting, diarrhea, and weight loss. CT of the abdomen and pelvis revealed evidence of gas in the mesentery, small bowel thickening, edema, and free fluid in the abdomen. Emergency exploratory laparotomy was conducted. Intraoperative findings included a perforated jejunum that was studded with nodular lesions as well as mesenteric masses. Histopathologic exam of these mesenteric masses and jejunal lesions were positive for histoplasmosis. Conclusion. Disseminated histoplasmosis is a life-threatening disease that occurs nearly exclusively in immunocompromised hosts. Untreated, mortality is as high as 80%. This rare presentation with jejunal perforation highlights the need for awareness of histoplasmosis involvement throughout the entirety of the GI tract.http://dx.doi.org/10.1155/2018/8923972 |
| spellingShingle | Bryan R. Anderson Jaron Marriott Chinthaka Bulathsinghala Humayun Anjum Salim Surani Gastrointestinal Histoplasmosis Presenting as an Acute Abdomen with Jejunal Perforation Case Reports in Medicine |
| title | Gastrointestinal Histoplasmosis Presenting as an Acute Abdomen with Jejunal Perforation |
| title_full | Gastrointestinal Histoplasmosis Presenting as an Acute Abdomen with Jejunal Perforation |
| title_fullStr | Gastrointestinal Histoplasmosis Presenting as an Acute Abdomen with Jejunal Perforation |
| title_full_unstemmed | Gastrointestinal Histoplasmosis Presenting as an Acute Abdomen with Jejunal Perforation |
| title_short | Gastrointestinal Histoplasmosis Presenting as an Acute Abdomen with Jejunal Perforation |
| title_sort | gastrointestinal histoplasmosis presenting as an acute abdomen with jejunal perforation |
| url | http://dx.doi.org/10.1155/2018/8923972 |
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