Li Chen-Xuan, Chen Hao-Dong, Kashif Shakoor, Xie Bin, Luo Jing, Li Ting
Department of Liver Transplantation, The Second Xiang-ya Hospital, Central South University, Changsha 410011, Hunan Province, China.
Transplant Medical Research Center, The Second Xiang-ya Hospital, Central South University, Changsha 410011, Hunan Province, China.
World J Gastroenterol. 2025 Mar 7;31(9):102059. doi: 10.3748/wjg.v31.i9.102059.
Histoplasmosis is a rare infectious condition with mainly pulmonary involvement which is generally self-limiting in immunocompetent individuals. Its manifestation varies and lacks specificity. This study reports a case of primary disseminated liver histoplasmosis in a normal host presenting as liver failure cured by liver transplantation and voriconazole.
A 43-year-old Chinese man with intermittent fever, malaise, jaundice and extreme hepatomegaly for more than 40 days was admitted to the Second Xiang-ya Hospital. The patient was immunocompetent and lacked a definitive history of exposure. His condition deteriorated to liver failure, and he promptly underwent liver transplantation to ensure survival. One year later, the patient presented with severe gastrointestinal symptoms, including fever, abdominal pain, and diarrhea. Subsequently, tissue samples acquired gastrointestinal endoscopy were subjected to pathological examination and next-generation sequencing analysis. Through a comprehensive amalgamation of clinical presentation, biopsy pathology, and next-generation sequencing analysis, the patient was ultimately diagnosed with disseminated hepatic histoplasmosis. The patient achieved complete recovery after 6 months of voriconazole treatment.
In patients with chronic-hepatitis-B having atypical symptoms, histoplasmosis can be a differential diagnosis. Voriconazole is effective in treating histoplasmosis.
组织胞浆菌病是一种罕见的感染性疾病，主要累及肺部，在免疫功能正常的个体中通常为自限性。其表现多样且缺乏特异性。本研究报告了一例正常宿主原发性播散性肝脏组织胞浆菌病病例，该病例表现为肝衰竭，经肝移植和伏立康唑治疗后治愈。
一名43岁的中国男性因间歇性发热、乏力、黄疸及肝脏极度肿大40余天入住中南大学湘雅二医院。该患者免疫功能正常，无明确的接触史。其病情恶化为肝衰竭，为确保生存，他迅速接受了肝移植。一年后，患者出现严重的胃肠道症状，包括发热、腹痛和腹泻。随后，对通过胃肠内镜获取的组织样本进行病理检查和二代测序分析。通过综合临床表现、活检病理及二代测序分析，该患者最终被诊断为播散性肝脏组织胞浆菌病。经伏立康唑治疗6个月后，患者完全康复。
对于出现非典型症状的慢性乙型肝炎患者，组织胞浆菌病可作为鉴别诊断。伏立康唑对治疗组织胞浆菌病有效。
