S3050 Obstructive Histoplasmosis Resulting in Recurrent Nausea and Vomiting

Gnecco, James; Dev, Ameesh; Penninti, Pranav; Echavarria, Juan; Ladak, Farah; Edelson, Jerome

doi:10.14309/01.ajg.0000785732.32168.de

Cited by 2 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%

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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%

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Ekeng

Itam-Eyo

Osaigbovo

et al. 2023

Life

View full text Add to dashboard Cite

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Section: Discussionmentioning

confidence: 99%

“…respiratory illness often in the immunocompetent 3–7 12. In those who are immunocompromised (most commonly due to HIV infection), histoplasmosis infection can become disseminated, affecting extrapulmonary sites including the gastrointestinal tract 1 3–7. Untreated disseminated histoplasmosis has a significant mortality of approximately 80% but medical management can significantly reduce this to 30% 2 5 6 13.…”

Section: Discussionmentioning

confidence: 99%

“…Prompt diagnosis of gastrointestinal histoplasmosis (GIH) is important as mortality is high if left untreated 1 2. Although GIH is commonly reported in patients who are immunocompromised, particularly patients living with HIV,3–8 it can also occur in patients without underlying HIV infection8 and in the immunocompetent 8 9. A low index of suspicion by the attending clinician or delayed diagnosis can lead to complications and fatal outcomes 1 8.…”

Section: Introductionmentioning

confidence: 99%

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Gastrointestinal histoplasmosis presenting as a small bowel obstruction in an immunocompetent patient

2023

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The clinical presentation of gastrointestinal histoplasmosis (GIH) is often non-specific, mimicking several other gastrointestinal diseases, making diagnosis difficult. We present a case of GIH, causing bowel obstruction in an immunocompetent patient. A woman in her 80s presented with anorexia and a distended abdomen. A CT scan of the abdomen and pelvis (CTAP) showed ileal thickening. Endoscopy was performed and ileal biopsies were taken. A diagnosis of histoplasmosis was made by histopathology, and she began treatment with liposomal amphotericin and itraconazole. Despite presenting well at her routine follow-up appointments, she presented 4 months after diagnosis with worsening symptoms of anorexia and abdominal distention. CTAP showed the ileal stricture causing bowel obstruction. She underwent itraconazole and steroid treatment while having nasogastric tube decompression. Subsequent gastrografin follow through showing partial obstruction and surgical resection was planned. Unfortunately, her condition deteriorated, her kidney function worsened and she suffered from aspiration pneumonia with eventual demise.

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S3050 Obstructive Histoplasmosis Resulting in Recurrent Nausea and Vomiting

Cited by 2 publications

References 0 publications

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Gastrointestinal Histoplasmosis: A Descriptive Review, 2001–2021

Gastrointestinal histoplasmosis presenting as a small bowel obstruction in an immunocompetent patient

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