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A case of gastrointestinal histoplasmosis with esophageal involvement

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Abstract

Histoplasmosis is a common infection endemic to the Ohio and Mississippi River Valleys caused by the inhalation of Histoplasma capsulatum spores from contaminated soil. Most infections are asymptomatic; however, patients with impaired cellular immunity (HIV infection, hematologic malignancy, solid organ transplant, hematopoietic stem cell transplant or TNF-⍺ inhibitor use) are at risk for disseminated disease. Disseminated histoplasmosis commonly affects the lungs, liver, spleen, bone marrow and gastrointestinal tract. Esophageal involvement is rare and usually due to extrinsic compression from affected mediastinal/hilar lymph nodes. Herein, we report a case of disseminated histoplasmosis in an AIDs patient involving the esophagus, without evidence of mediastinal involvement.

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References

  1. Kauffman CA. Histoplasmosis: a clinical and laboratory update. Clin Microbiol Rev. 2007;20:115–32.

    Article  CAS  Google Scholar 

  2. Azar MM, Hage CA. Laboratory diagnostics for histoplasmosis. J Clin Microbiol. 2017;55:1612–20.

    Article  CAS  Google Scholar 

  3. Horwath MC, Fecher RA, Deepe GS. Histoplasma capsulatum, lung infection and immunity. Future Microbiol. 2015;10:967–75.

    Article  CAS  Google Scholar 

  4. Gilliland MD, Scott LD, Walker WE. Esophageal obstruction caused by mediastinal histoplasmosis: beneficial results of operation. Surgery. 1984;95:59–62.

    CAS  PubMed  Google Scholar 

  5. Khan AN, Al-Jahdali HH, Allen CM, et al. The calcified lung nodule: what does it mean? Ann Thorac Med. 2010;5:67–79.

    Article  Google Scholar 

  6. Zanotti P, Chirico C, Gulletta M, et al. Disseminated histoplasmosis as AIDS-presentation. Case report and comprehensive review of current literature. Mediter J of Hematol Infect Dis. 2018;10:e20188040.

    Google Scholar 

  7. Suh KN, Anekthananon T, Mariuz PR. Gastrointestinal histoplasmosis in patients with AIDS: case report and review. Clin Infec Dis. 2001;32:483–91.

    Article  CAS  Google Scholar 

  8. Kahi CJ, Wheat LJ, Allen SD. Gastrointestinal histoplasmosis. Am J Gastroenterol. 2005;100:220–31.

    Article  Google Scholar 

  9. Wheat LJ, Connolly-Stringfield PA, Baker RL, et al. Disseminated histoplasmosis in the acquired immune deficiency syndrome: clinical findings, diagnosis and treatment, and review of the literature. Medicine. 1990;69:361–74.

    Article  CAS  Google Scholar 

  10. Assi M, McKinsey DS, Driks MR, et al. Gastrointestinal histoplasmosis in the acquired immunodeficiency syndrome: report of 18 cases and literature review. Diagn Microbiol Infect Dis. 2006;55:195–201.

    Article  Google Scholar 

  11. Zamora JAG, Espinoza LA. Histoplasma and cytomegalovirus coinfection of the gastrointestinal tract in a patient with AIDS: a case report and review of the literature. Diseases. 2017;5:30–8.

    Article  Google Scholar 

  12. Chaudhari D, Mckinney J, Hubbs D, et al. Mediastinal histoplasmosis presenting as dysphagia: a case report with literature review. Clin J Gastroenterol. 2013;6:315–8.

    Article  Google Scholar 

  13. Spinner MA, Paulin HN, Wester CW. Duodenal histoplasmosis presenting with upper gastrointestinal bleeding in an AIDS patient. Case Rep Gastrointest Med. 2012;2012:515827.

    Google Scholar 

  14. Gumbs MA, Girishkumar H, Yousuf A, et al. Histoplasmosis of the small bowel in patients with AIDS. Postgrad Med J. 2000;76:364–72.

    Article  Google Scholar 

  15. Moore T. Esophageal obstruction due to mediastinal granuloma. J Thorac Surg. 1959;37:127–34.

    CAS  PubMed  Google Scholar 

  16. Christodoupoulos J, Klotz A. Esophageal obstruction due to granulomatous mediastinal lymphadenopathy. Gastroenterology. 1961;40:574–9.

    Article  Google Scholar 

  17. Marshall JB, Singh R, Demmy TL, et al. Mediastinal histoplasmosis presenting with esophageal involvement and dysphagia: case study. Dysphagia. 1995;10:53–8.

    Article  CAS  Google Scholar 

  18. Savides TJ, Gress FG, Wheat LJ, et al. Dysphagea due to mediastinal granulomas: diagnosis with endoscopic ultrasonography. Gastroenterology. 1995;109:366–73.

    Article  CAS  Google Scholar 

  19. Mandavdhar HS, Shah J, Prasad KK, et al. Gastrointestinal histoplasmosis: a case series from a non-endemic region in North India. Intest Res. 2019;17:149–52.

    Article  Google Scholar 

  20. Forsmark CE, Wilcox CM, Darragh TM, et al. Disseminated histoplasmosis in AIDS: an unusual case of esophageal involvement and gastrointestinal bleeding. Gastrointest Endosc. 1990;36:604–5.

    Article  CAS  Google Scholar 

  21. Sharma LC, Falodia J, Kalla K, et al. Esophageal histoplasmosis in a renal allograft recipient. Saudi J Kidney Dis Transpl. 2003;24(4):764–7.

    Google Scholar 

  22. Forsmark CE, Wilcox CM, Darragh TM, et al. Disseminated histoplasmosis in AIDS: an unusual case of esophageal involvement and gastrointestinal bleeding. Gastrointest Endos. 1990;36:604–5.

    Article  CAS  Google Scholar 

  23. Wheat J, Freifeld AG, Kleiman MB, et al. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the infectious disease society of America. Clin Infect Dis. 2007;45:807–25.

    Article  Google Scholar 

  24. Yamazaki T, Inagaki Y, Fujii T, et al. In vitro activity of isavuconazole against 140 reference fungal strains and 165 clinically isolated yeasts from Japan. Int J Antimicrob Agents. 2010;36:324–31.

    Article  CAS  Google Scholar 

  25. Thompson GR, Rendon A, Ribeiro Dos Santos R, et al. Isavuconazole treatment of cryptococcosis and dimorphic mycoses. Clin Infect Dis. 2016;63:356–62.

    Article  CAS  Google Scholar 

  26. Spec A, Connolly P, Montejano R, et al. In vitro activity of isavuconazole against fluconazole-resistant isolates of histoplasma capsulatum. Med Mycol. 2018;56:834–7.

    Article  CAS  Google Scholar 

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Correspondence to Paras Patel.

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Mathew Finniss, Paul Lewis, James Myers, Lamis Ibrahim and Paras Patel declare that they have no conflict of interest.

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Finniss, M., Lewis, P., Myers, J. et al. A case of gastrointestinal histoplasmosis with esophageal involvement. Clin J Gastroenterol 13, 173–177 (2020). https://doi.org/10.1007/s12328-019-01036-z

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