Rai Vanya, Goyal Rohit, Vyas Aditya, Sachdeva Karan, Arora Kshitij, Zia Hassan
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
Department of Internal Medicine, Louisiana State University Health Shreveport, Shreveport, LA.
ACG Case Rep J. 2025 Aug 1;12(8):e01781. doi: 10.14309/crj.0000000000001781. eCollection 2025 Aug.
Histoplasmosis has a wide spectrum of presentations ranging from mild pulmonary disease to a more widespread infection leading to disseminated histoplasmosis. Gastrointestinal histoplasmosis is a rare form of disseminated histoplasmosis that most commonly causes nonspecific symptoms and rarely presents with serious symptoms. Duodenal involvement is further rare but can cause ulcerated lesions leading to upper gastrointestinal bleed. The potential for a nonspecific initial presentation quickly progressing to a fatal upper gastrointestinal bleed makes it important to keep Gastrointestinal histoplasmosis in our list of differentials, as timely initiation of appropriate antifungal therapy can significantly reduce the risk of severe complications and mortality.
组织胞浆菌病有广泛的表现形式，从轻度肺部疾病到更广泛的感染，导致播散性组织胞浆菌病。胃肠道组织胞浆菌病是播散性组织胞浆菌病的一种罕见形式，最常见的是引起非特异性症状，很少出现严重症状。十二指肠受累更是罕见，但可导致溃疡性病变，进而引起上消化道出血。由于非特异性初始表现可能迅速发展为致命的上消化道出血，因此将胃肠道组织胞浆菌病列入鉴别诊断清单很重要，因为及时开始适当的抗真菌治疗可显著降低严重并发症和死亡率的风险。
