Dahiya D, Kichloo A, Singh J, Albosta M, Wani F. Histoplasmosis and inflammatory bowel disease: A case report. World J Gastrointest Endosc 2021; 13(1): 24-32 [PMID: 33520104 DOI: 10.4253/wjge.v13.i1.24]
Corresponding Author of This Article
Michael Albosta, MD, Doctor, Internal Medicine, Central Michigan University, 1632 Stone Street, Saginaw, MI 48603, United States. albos1ms@cmich.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jan 16, 2021; 13(1): 24-32 Published online Jan 16, 2021. doi: 10.4253/wjge.v13.i1.24
Histoplasmosis and inflammatory bowel disease: A case report
Dushyant Dahiya, Asim Kichloo, Jagmeet Singh, Michael Albosta, Farah Wani
Dushyant Dahiya, Asim Kichloo, Michael Albosta, Internal Medicine, Central Michigan University, Saginaw, MI 48603, United States
Asim Kichloo, Farah Wani, Internal Medicine, Samaritan Medical Center, Watertown, NY 13601, United States
Jagmeet Singh, Internal Medicine, Guthrie Robert Packer Hospital, Sayre, PA 18840, United States
Author contributions: Dahiya D and Kichloo A contributed to the conceptualization, methodology, supervision, writing-original draft, and writing-review and editing; Singh J, Albosta M, and Wani F each contributed to the writing-original draft, and revision of critically important intellectual content; all authors have given final approval of the version of the article to be published.
Informed consent statement: Written informed consent was obtained from the patient for the anonymized information.
Conflict-of-interest statement: The authors report no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Michael Albosta, MD, Doctor, Internal Medicine, Central Michigan University, 1632 Stone Street, Saginaw, MI 48603, United States. albos1ms@cmich.edu
Received: October 19, 2020 Peer-review started: October 19, 2020 First decision: December 1, 2020 Revised: December 2, 2020 Accepted: December 16, 2020 Article in press: December 16, 2020 Published online: January 16, 2021 Processing time: 81 Days and 10.3 Hours
Abstract
BACKGROUND
Infection with Histoplasma capsulatum can lead to a disseminated disease involving the gastrointestinal tract presenting as diffuse abdominal pain and inflammatory diarrhea which may mimic inflammatory bowel disease (IBD).
CASE SUMMARY
In the current report, we discuss the case of a 41-year old male who presented to the emergency department with complaints of high-grade intermittent fevers and severe abdominal pain with associated diarrhea and hematochezia. Laboratory results demonstrated transaminitis and elevated erythrocyte sedimentation rate, C-reactive protein and ferritin levels. The patient’s presentation was thought to be an exacerbation of his underlying IBD, but further investigations revealed a positive Histoplasma antigen in the urine. The patient was offered a colonoscopy and biopsy to confirm the diagnosis; however, he refused. He was treated with itraconazole and showed significant improvement of his symptoms, thereby confirming the diagnosis of gastrointestinal histoplasmosis.
CONCLUSION
Here within, we provide a review of IBD, evaluation of chronic diarrhea, and gastrointestinal histoplasmosis.
Core Tip: Histoplasmosis can lead to a disseminating disease state affecting a large number of organ systems, leading to a wide range of pathology. This includes the gastrointestinal tract. We present herein, a case of gastrointestinal histoplasmosis in a patient with long standing ulcerative colitis that presented in a manner very similar to acute exacerbation of inflammatory bowel disease. This case highlights the importance of keeping gastrointestinal histoplasmosis amongst the differential diagnoses in cases that present similarly to acute exacerbation of inflammatory bowel disease in order to prevent inappropriate delays in diagnosis, unnecessary procedures, and increased morbidity and mortality.
