Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 May 16;8(7):ofab249.
doi: 10.1093/ofid/ofab249. eCollection 2021 Jul.

Gastrointestinal Histoplasmosis Mimicking Crohn's Disease

Esfandiar Shojaei  1 , Joanna C Walsh  2 , Nikhil Sangle  2 , Brian Yan  3 , Michael S Silverman  1   4 , Seyed M Hosseini-Moghaddam  1   5
Affiliations
Case Reports

Gastrointestinal Histoplasmosis Mimicking Crohn's Disease

Esfandiar Shojaei et al. Open Forum Infect Dis. .

Abstract

Disseminated histoplasmosis is a life-threatening disease usually seen in immunocompromised patients living in endemic areas. We present an apparently immunocompetent patient with gastrointestinal histoplasmosis who was initially diagnosed with biopsy-proven Crohn's disease. Following discontinuation of anti-inflammatory drugs and institution of antifungal therapy, his gastrointestinal illness completely improved. Specific fungal staining should be routinely included in histopathologic assessment of tissue specimens diagnosed as Crohn's disease.

Keywords: alcoholism; gastrointestinal histoplasmosis; inflammatory bowel disease.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Endoscopy of the ascending colon (A) and cecum (B) demonstrating erosion and ulceration.
Figure 2.
Figure 2.
A, Hematoxylin and eosin–stained section of the colonic biopsy reveals diffuse cellular infiltrate within the lamina propria (×100). B, Higher magnification of the biopsy (×200) shows an ill-defined noncaseating epithelioid cell granuloma (yellow circle). C, In other areas of the same section (×200), there were few multinucleated giant cells (yellow arrow). D, Special stain, Grocott-Gomori’s Methenamine Silver–Fungal, highlights several yeast forms of histoplasmosis scattered throughout the lamina propria (×400; yellow arrow).
Figure 3.
Figure 3.
The timeline of different diagnostic tests. Abbreviations: BAL, bronchoalveolar lavage; GI, gastrointestinal; GIH, GI histoplasmosis; PCR, polymerase chain reaction.
See this image and copyright information in PMC

References

    1. Assi MA, Sandid MS, Baddour LM, et al. . Systemic histoplasmosis: a 15-year retrospective institutional review of 111 patients. Medicine (Baltimore) 2007; 86:162–9. - PubMed
    1. Kahi CJ, Wheat LJ, Allen SD, Sarosi GA. Gastrointestinal histoplasmosis. Am J Gastroenterol 2005; 100:220–31. - PubMed
    1. Romano RC, Soape MM, Thirumala S, Ghandour E. Disseminated histoplasmosis mimicking metastatic disease of the colon and omentum: report of a case and literature review. Arab J Gastroenterol 2015; 16:66–8. - PubMed
    1. Psarros G, Kauffman CA. Colonic histoplasmosis: a difficult diagnostic problem. Gastroenterol Hepatol (N Y) 2007; 3:461–3. - PMC - PubMed
    1. Ai XB, Wang ZJ, Dong QC, et al. . Ileum histoplasmosis mimicking intestinal tuberculosis and Crohn’s disease. Case Rep Gastroenterol 2018; 12:63–8. - PMC - PubMed

Publication types