Intestinal perforation from gastrointestinal histoplasmosis in acquired immunodeficiency syndrome. Case report and review of the literature
S. J. Heneghan, J. Li, E. Petrossian and L. S. Bizer
Department of Surgery, North Central Bronx Hospital, NY 10467.
Gastrointestinal involvement with histoplasmosis in patients with the
acquired immunodeficiency syndrome is a rare but documented phenomenon.
Most patients present with diarrhea, fever, and abdominal pain. We present
a case of a woman who tested positive for the human immunodeficiency virus
antibody who developed an intestinal perforation due to Histoplasma
capsulatum of the ileum. The patient, whose only risk factor was a blood
transfusion 8 years earlier, had been previously diagnosed as having
disseminated histoplasmosis with gastrointestinal involvement. While
receiving oral antifungal treatment (itraconazole), she developed two
separate areas of ileal perforation due to H capsulatum. Complications from
gastrointestinal involvement with histoplasmosis, such as perforation,
should be considered in patients infected with the human immunodeficiency
virus with signs and symptoms suggesting abdominal disease.
