Sanguino J C, Rodrigues B, Baptista A, Quina M
Clinica Universitaria de Medicina Interna e Gastrenterologia, Hospital de Pulido Valente, Lisboa, Portugal.
Hepatogastroenterology. 1996 May-Jun;43(9):771-5.
We describe the case of a localized lesion of African Histoplasmosis, presenting as a gastric ulcer, with radiological and endoscopic features suggesting malignancy, that was submitted to surgery. Histologic examination of the resected specimen revealed typical yeasts of Histoplasma duboisii. There where no clinical, radiological or endoscopic signs of disseminated disease and conventional antifungal therapy was not prescribed. The patient has been followed for 11 years now, without evidence of relapse. There are few reports of gastrointestinal Histoplasmosis, and even fewer specifically caused by H. Duboissii Previous descriptions of gastric ulcer in immunocompetent hosts are related to disseminated forms of American Histoplasmosis. Although focal digestive lesions have been found in African patients, there is no available data on the incidence of gastric ulcer as a presenting sign of the disease.
我们描述了一例非洲组织胞浆菌病局限性病变的病例,表现为胃溃疡,其放射学和内镜特征提示为恶性肿瘤,遂接受了手术治疗。对切除标本的组织学检查发现了典型的杜波依斯组织胞浆菌酵母。没有临床、放射学或内镜检查显示有播散性疾病的迹象,也未给予常规抗真菌治疗。该患者目前已随访11年,无复发迹象。关于胃肠道组织胞浆菌病的报道很少,由杜波依斯组织胞浆菌引起的病例更是少之又少。先前关于免疫功能正常宿主胃溃疡的描述与播散型美洲组织胞浆菌病有关。虽然在非洲患者中发现了局灶性消化系统病变,但尚无关于胃溃疡作为该病首发症状发生率的可用数据。