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April 1993

Intestinal Perforation From Gastrointestinal Histoplasmosis in Acquired Immunodeficiency Syndrome: Case Report and Review of the Literature

Author Affiliations

From the Departments of Surgery (Drs Heneghan, Petrossian, and Bizer) and Pathology (Dr Li), North Central Bronx (NY) Hospital, Montefiore Medical Center, and the Albert Einstein College of Medicine, Bronx.

Arch Surg. 1993;128(4):464-466. doi:10.1001/archsurg.1993.01420160106018

• 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.

(Arch Surg. 1993;128:464-466)

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