Systemic histoplasmosis with oesophageal obstruction due to Histoplasma granulomas. Successful treatment with rifampicin and amphotericin B.

A patient with oesophageal stenosis caused by Histoplasma granulomas is reported. He was treated with an initial combined course of intravenous amphotericin B and oral rifampicin. Complications included adrenal insufficiency, operative perforation of the oesophagus, amphotericin nephrotoxicity and tuberculosis. The histoplasmosis has not recurred for over 3 years.