A case of gastrointestinal histoplasmosis with esophageal involvement

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

“…The non-specific signs and symptoms of GIH, as highlighted in this review, include but are not limited to abdominal pain [ 12 , 18 , 19 , 20 , 20 , 21 , 22 , 25 , 27 , 31 , 33 , 35 , 36 , 37 , 38 , 40 , 41 , 43 , 45 , 47 , 50 , 51 , 54 ], diarrhoea [ 12 , 17 , 19 , 21 , 22 , 36 , 37 , 38 , 39 , 40 , 43 , 53 , 68 , 74 , 75 , 103 , 104 , 105 , 106 ], fever [ 12 , 13 , 17 , 19 , 26 , 27 , 28 , 30 , 31 , 33 , 35 ], weight loss [ 13 , 31 , 77 , 79 , 84 , …”

“…The prevalence of oesophageal histoplasmosis is also higher in individuals with HIV/AIDS, which is said to occur in 3–3.8% of cases [ 12 , 13 ]. Oesophageal histoplasmosis is linked to the early phase of histoplasmosis infection predominantly due to adjoining mediastinal adenitis [ 6 , 75 ] or later from progressive scarring in fibrosing mediastinitis or disseminated disease [ 6 , 82 ].…”

“…Oesophageal histoplasmosis is linked to the early phase of histoplasmosis infection predominantly due to adjoining mediastinal adenitis [ 6 , 75 ] or later from progressive scarring in fibrosing mediastinitis or disseminated disease [ 6 , 82 ]. Endoscopic findings in GIH involving the oesophagus could be erythema or local inflammation [ 40 , 42 , 56 , 58 , 105 ], polyps [ 13 ] and ulcerations [ 20 , 84 , 100 , 104 , 121 ]. During the period under review, twelve patients [ 13 , 20 , 40 , 42 , 48 , 56 , 58 , 84 , 100 , 104 , 105 , 121 ] presented with GIH with oesophageal involvement and five were immunocompromised [ 13 , 40 , 100 , 104 , 121 ] with HIV infection.…”

“…Endoscopic findings in GIH involving the oesophagus could be erythema or local inflammation [ 40 , 42 , 56 , 58 , 105 ], polyps [ 13 ] and ulcerations [ 20 , 84 , 100 , 104 , 121 ]. During the period under review, twelve patients [ 13 , 20 , 40 , 42 , 48 , 56 , 58 , 84 , 100 , 104 , 105 , 121 ] presented with GIH with oesophageal involvement and five were immunocompromised [ 13 , 40 , 100 , 104 , 121 ] with HIV infection. Treatment with intravenous amphotericin B and itraconazole [ 13 , 40 , 42 , 48 , 56 , 58 , 84 , 104 , 105 , 121 ] resulted in a favourable outcome; one patient died due to dual opportunistic infection with tuberculosis [ 100 ] and the other died before treatment was commenced [ 20 ].…”

HIV-associated disseminated histoplasmosis successfully treated with isavuconazole consolidation therapy

“…Out of the four with disseminated disease, half had treatment success, one had a partial success, and another had progression. Isavuconazole was also used successfully in a case of Histoplasma endocarditis [10] and in a case of oesophageal histoplasmosis in the context of advanced HIV infection [11].…”