Case report
Histoplasmosis of the small bowel in patients with AIDS
Milton A Gumbsa, Hanasoge Girishkumara, Arshad Yousufa, Leo Levyb, Mayank Patela, Vijay Narasimhaa
a Department
of Surgery, Bronx-Lebanon Hospital Center, Bronx, New York, USA, b Department of
Pathology
Correspondence to: Mrs Saundra King, Administrative Coordinator, Department of Surgery, Bronx-Lebanon Hospital Center, 1650 Selwyn Ave, Suite 4A, Bronx, New York 10457, USA (e-mail: saunking{at}aol.com)
Submitted 21 April 1999;
Accepted 16 November 1999
Two cases of jejunal strictures caused by
Histoplasma capsulatum in AIDS
patients are presented. Both patients were intravenous drug abusers.
One patient, who was being treated for Pneumocystis carnii pneumonia, presented with jejunal
perforation and the other presented with lower gastrointestinal
bleeding and intestinal obstruction. On exploration, both patients were
found to have jejunal strictures; one had intestinal perforation, and
the other had intestinal obstruction with ulcers and strictures
resulting in gastrointestinal bleeding. In areas where it is endemic,
histoplasmosis is rarely disseminated. Dissemination is most commonly
seen in immunosuppressed patients. Dissemination and extrapulmonary
histoplasmosis is now included in the case definition of AIDS.
Keywords: histoplasmosis; AIDS; jejunal perforation
© 2000 by The Fellowship of Postgraduate Medicine
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GI bleeding
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Drugs: infectious diseases
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