Duodenal Histoplasmosis Presenting with Upper Gastrointestinal Bleeding in an AIDS Patient

المؤلفون المشاركون

Spinner, Michael A.
Wester, C. William
Paulin, Heather N.

المصدر

Case Reports in Gastrointestinal Medicine

العدد

المجلد 2012، العدد 2012 (31 ديسمبر/كانون الأول 2012)، ص ص. 1-4، 4ص.

الناشر

Hindawi Publishing Corporation

تاريخ النشر

2012-10-03

دولة النشر

مصر

عدد الصفحات

4

التخصصات الرئيسية

الأمراض

الملخص EN

Gastrointestinal histoplasmosis (GIH) is common in patients with disseminated disease but only rarely comes to clinical attention due to the lack of specific signs and symptoms.

We report the unusual case of a 33-year-old Caucasian male with advanced AIDS who presented with upper GI bleeding from diffuse erosions throughout the duodenum.

Biopsy of the lesions revealed small bowel mucosa with granulomatous inflammation and macrophages with small intracellular yeasts consistent with disseminated histoplasmosis.

The patient demonstrated significant clinical improvement following a two-week course of liposomal amphotericin B.

To our knowledge, this is the first case report of duodenal histoplasmosis leading to clinically significant bleeding, manifesting with worsening anemia and melanotic stools.

Given our findings, we maintain that GIH should be considered on the differential diagnosis for GI bleeding in AIDS patients at risk, specifically those with advanced immunosuppression (i.e., CD4+ cell counts <100 cells/mm3) who reside in endemic areas (Ohio or Mississippi river valleys) and/or have a prior history of histoplasmosis.

For diagnostic evaluation, we recommend checking a urine Histoplasma quantitative antigen EIA as well as upper and/or lower endoscopy with biopsy.

We recommend treatment with a two-week course of liposomal amphotericin B followed by indefinite itraconazole.

نمط استشهاد جمعية علماء النفس الأمريكية (APA)

Spinner, Michael A.& Paulin, Heather N.& Wester, C. William. 2012. Duodenal Histoplasmosis Presenting with Upper Gastrointestinal Bleeding in an AIDS Patient. Case Reports in Gastrointestinal Medicine،Vol. 2012, no. 2012, pp.1-4.
https://search.emarefa.net/detail/BIM-477821

نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)

Spinner, Michael A.…[et al.]. Duodenal Histoplasmosis Presenting with Upper Gastrointestinal Bleeding in an AIDS Patient. Case Reports in Gastrointestinal Medicine No. 2012 (2012), pp.1-4.
https://search.emarefa.net/detail/BIM-477821

نمط استشهاد الجمعية الطبية الأمريكية (AMA)

Spinner, Michael A.& Paulin, Heather N.& Wester, C. William. Duodenal Histoplasmosis Presenting with Upper Gastrointestinal Bleeding in an AIDS Patient. Case Reports in Gastrointestinal Medicine. 2012. Vol. 2012, no. 2012, pp.1-4.
https://search.emarefa.net/detail/BIM-477821

نوع البيانات

مقالات

لغة النص

الإنجليزية

الملاحظات

Includes bibliographical references

رقم السجل

BIM-477821