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Case Reports
. 2023 Oct 3;10(10):e01173.
doi: 10.14309/crj.0000000000001173. eCollection 2023 Oct.

Disseminated Histoplasmosis Presenting as Obstructive Jaundice

Laith Numan  1 , Wail A Hayajneh  2 , Wissam Kiwan  1
Affiliations
Case Reports

Disseminated Histoplasmosis Presenting as Obstructive Jaundice

Laith Numan et al. ACG Case Rep J. .

Abstract

Gastrointestinal manifestations in systemic fungal infection are not uncommon; however, obstructive jaundice due to lymphadenopathy is considered rare. We present a case of a 16-year-old male patient who presented with painless jaundice. Laboratory tests revealed direct hyperbilirubinemia with cholestatic liver injury. Chest and abdominal computed tomography showed mediastinal and porta hepatis lymphadenopathy, with severe biliary ductal dilatation proximal to an obstructing lymph node near the head of the pancreas. Endoscopic ultrasound showed a 22 × 35-mm lymph node with a mass effect on the common bile duct leading to obstructive jaundice. Infectious workup confirmed the diagnosis of disseminated histoplasmosis.

Keywords: ERCP; endoscopic ultrasound; histoplasmosis; lymphadenopathy; obstructive jaundice.

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Figures

Figure 1.
Figure 1.
Endoscopic ultrasound of the large lymph node near the head of the pancreas causing biliary obstruction.
Figure 2.
Figure 2.
Fluoroscopic image from the endoscopic retrograde cholangiopancreatography showing the stricture (yellow arrow) and the dilated common bile duct (blue arrow).
Figure 3.
Figure 3.
Fluoroscopic image from the endoscopic retrograde cholangiopancreatography after the patient received treatment showing improvement in the distal common bile duct dilatation.
See this image and copyright information in PMC

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