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Disseminated Histoplasmosis: Intestinal Multiple Ulcers without Gastrointestinal Symptoms in an Immune Competent Adult

Abstract

Linlin Zhu, Wenyan Zhang, Li Yang, Tianjiao Guo, Chang Su and Jinlin Yang

Gastrointestinal involvement in disseminated histoplasmosis can occur at any site along the GI tract without specific manifestations, although causes clinical symptoms in only 3–12% of patients. Intestinal histoplasmosis is the most common one, particularly at the terminal ileum as it’s abundant in lymphoid tissue. Endoscopic findings in the intestines were from erythema, edema, ulcers to perforation. As the lack of specificity of these manifestations in symptoms and colonoscopy, intestinal histoplasmosis may be misdiagnosed, leading to inappropriate therapies and unnecessary surgical interventions. We report a case of immunocompetent disseminated histoplasmosis involving the colon and terminal ileum which presented fever and weight loss without gastrointestinal symptoms. So taking disseminated histoplasmosis as differential diagnosis even in immunocompetent asymptomatic patients is necessary for gastroenterologists and endoscopists.

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