Cui Min, Wong Richard C K, Gholam Pierre M
Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH.
Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Cleveland, OH.
ACG Case Rep J. 2021 May 18;8(5):e00598. doi: 10.14309/crj.0000000000000598. eCollection 2021 May.
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.
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。
