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Case Reports
. 2021 May 18;8(5):e00598.
doi: 10.14309/crj.0000000000000598. eCollection 2021 May.

Colonic Histoplasmosis Presenting as Polyps in an Asymptomatic Patient With Liver Transplant

Min Cui  1 , Richard C K Wong  2 , Pierre M Gholam  2
Affiliations
Case Reports

Colonic Histoplasmosis Presenting as Polyps in an Asymptomatic Patient With Liver Transplant

Min Cui et al. ACG Case Rep J. .

Abstract

Infection of the gastrointestinal tract by Histoplasma capsulatum is generally considered to be a manifestation of disseminated disease. The most common symptoms from gastrointestinal histoplasmosis include abdominal pain and diarrhea. Isolated asymptomatic gastrointestinal histoplasmosis is unusual, and diagnosis can be challenging. We report a 57-year-old man with a history of liver transplant presented with numerous colonic polyps, and the biopsies demonstrated granulomatous colitis with fungal microorganism consistent with H. capsulatum. Antigen/antibody tests for Histoplasma were confirmatory. The patient was asymptomatic with no clinical or radiological evidence of pulmonary involvement. He responded well to itraconazole treatment, and urine antigen tested negative 6 months after the initiation of the treatment. Follow-up colonoscopy performed 12 months after treatment with itraconazole showed no evidence of colonic histoplasmosis.

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Figures

Figure 1.
Figure 1.
Endoscopic image of an ascending colon polyp.
Figure 2.
Figure 2.
Colonic mucosa with aulcerated surface, lamina propria expanded by inflammatory cells and granuloma (black arrow).
Figure 3.
Figure 3.
Intracytoplasmic fungal microorganism (black arrows) seen in histiocytes on hematoxylin and eosin stain.
Figure 4.
Figure 4.
Grocott methenamine silver stain highlighting the fungal microorganism in black.
See this image and copyright information in PMC

References

    1. Wheat LJ, Freifeld AG, Kleiman MB, et al. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis. 2007;45(7):807–25. - PubMed
    1. Cappell MS, Mandell W, Grimes MM, et al. Gastrointestinal histoplasmosis. Dig Dis Sci. 1988;33(3):353–60. - PubMed
    1. Lamps LW, Molina CP, West AB, et al. The pathologic spectrum of gastrointestinal and hepatic histoplasmosis. Am J Clin Pathol. 2000;113(1):64–72. - PubMed
    1. Hamada Y, Tanaka K, Horiki N, et al. Colonic histoplasmosis resembling early colon cancer. Gastrointest Endosc. 2020;91(4):951–2. - PubMed
    1. Saad P, Zamil H, Catalano MF. Colonic perforation due to GI histoplasmosis in an immunocompetent host mimicking Crohn's disease. Gastrointest Endosc. 2018;88(1):192–3. - PubMed

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