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肝移植无症状患者中表现为息肉的结肠组织胞浆菌病

Colonic Histoplasmosis Presenting as Polyps in an Asymptomatic Patient With Liver Transplant.

作者信息

Cui Min, Wong Richard C K, Gholam Pierre M

机构信息

Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH.

Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Cleveland, OH.

出版信息

ACG Case Rep J. 2021 May 18;8(5):e00598. doi: 10.14309/crj.0000000000000598. eCollection 2021 May.

Abstract

Infection of the gastrointestinal tract by is generally considered to be a manifestation of disseminated disease. The most common symptoms from gastrointestinal histoplasmosis include abdominal pain and diarrhea. Isolated asymptomatic gastrointestinal histoplasmosis is unusual, and diagnosis can be challenging. We report a 57-year-old man with a history of liver transplant presented with numerous colonic polyps, and the biopsies demonstrated granulomatous colitis with fungal microorganism consistent with . Antigen/antibody tests for were confirmatory. The patient was asymptomatic with no clinical or radiological evidence of pulmonary involvement. He responded well to itraconazole treatment, and urine antigen tested negative 6 months after the initiation of the treatment. Follow-up colonoscopy performed 12 months after treatment with itraconazole showed no evidence of colonic histoplasmosis.

摘要

胃肠道感染通常被认为是播散性疾病的一种表现。胃肠道组织胞浆菌病最常见的症状包括腹痛和腹泻。孤立的无症状胃肠道组织胞浆菌病并不常见,诊断可能具有挑战性。我们报告一名57岁有肝移植病史的男性,其出现大量结肠息肉,活检显示为肉芽肿性结肠炎,伴有与组织胞浆菌相符的真菌微生物。组织胞浆菌的抗原/抗体检测呈阳性。该患者无症状,无肺部受累的临床或影像学证据。他对伊曲康唑治疗反应良好,治疗开始6个月后尿抗原检测呈阴性。伊曲康唑治疗12个月后进行的随访结肠镜检查显示无结肠组织胞浆菌病的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c378/8443831/1ca5ee9e4ead/ac9-8-e00598-g001.jpg

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