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Author Doleschal, Bernhard ♦ Rödhammer, Therese ♦ Aichberger, KARL J. ♦ Lang, Franz ♦ Tsybrovskyy, Oleksiy
Source Directory of Open Access Journals (DOAJ)
Content type Text
Publisher Karger Publishers
File Format HTM / HTML
Date Created 2016-11-11
Copyright Year ©2016
Language English
Subject Domain (in LCC) RC799-869
Subject Keyword Disseminated histoplasmosis ♦ Systemic illness ♦ Nonendemic area ♦ Oral ulcers ♦ Internal medicine ♦ Diseases of the digestive system ♦ Medicine ♦ Nonimmunocompromised patient ♦ Gastroenterology ♦ Colonic lesions ♦ Specialties of internal medicine
Abstract Histoplasmosis is well characterized as an endemic fungal disease restricted to certain areas of the USA. In Middle Europe, most patients present with acute pulmonary symptoms after travelling to endemic areas. Here, we want to illustrate the case of a 67-year-old man who presented with persistent oral ulcers, hoarseness, dysphagia, diarrhea, and weight loss to our Department of Otorhinolaryngology in December 2014. He was a retired construction worker and had a history of soil-disruptive activities in Africa and Middle and South America during employment. A positron emission tomography-computed tomography scan revealed prominent hypermetabolic lesions in the cecum and the lung, pointing towards a malignant disease. Surprisingly, histological examination of colonic and oral biopsies revealed abundant intracellular fungal elements, highly suspicious of Histoplasma capsulatum. Diagnosis was finally confirmed by panfungal polymerase chain reaction. Upon treatment with liposomal amphotericin followed by itraconazole, the severely ill patient showed an impressive clinical response. This case describes a disseminated manifestation of H. capsulatum years after the first exposure in an otherwise immunocompetent patient descending from a nonendemic area.
ISSN 16620631
Age Range 18 to 22 years ♦ above 22 year
Educational Use Research
Education Level UG and PG ♦ Career/Technical Study
Learning Resource Type Article
Publisher Date 2016-11-01
e-ISSN 16620631
Journal Case Reports in Gastroenterology
Volume Number 10
Issue Number 3
Page Count 8
Starting Page 653
Ending Page 660

Source: Directory of Open Access Journals (DOAJ)