Kane S, Brasitus T
The University of Chicago Hospitals, Illinois, USA.
Dig Dis Sci. 2000 Nov;45(11):2133-5. doi: 10.1023/a:1026680317424.
Infection with Histoplasma capsulatum is the most common systemic fungal infection in the United States, but symptomatic gastrointestinal disease is rare. Gastrointestinal involvement is seen in patients with an established immunosuppressed state that predates any infection. We report a patient presenting with gastrointestinal bleeding ultimately diagnosed with disseminated histoplasmosis. Work-up led to the diagnosis of common variable immunodeficiency, a diagnosis not previously described as associated with gastrointestinal histoplasmosis. Resolution of the colonic ulcer was documented after appropriate antifungal therapy, underscoring the importance of including this infectious process in the differential of a patient without other risk factors for colonic ulceration.
荚膜组织胞浆菌感染是美国最常见的全身性真菌感染，但有症状的胃肠道疾病却很罕见。胃肠道受累见于已有免疫抑制状态且早于任何感染的患者。我们报告了一名以胃肠道出血为表现最终被诊断为播散性组织胞浆菌病的患者。检查导致诊断出常见可变免疫缺陷，此前未曾有过这种诊断与胃肠道组织胞浆菌病相关的描述。经适当抗真菌治疗后记录到结肠溃疡已愈合，这突出了在没有其他结肠溃疡危险因素的患者鉴别诊断中纳入这一感染过程的重要性。
