Unusual gastrointestinal histoplasmosis with jejunal perforation in a 57-year-old patient from Bogota: case report

Abstract

Histoplasmosis is an endemic fungal infection caused by Histoplasma species. Disseminated forms, although rare, often involve the gastrointestinal tract and primarily affect immunocompromised patients. This paper presents an unusual case of gastrointestinal histoplasmosis with jejunal perforation. A 57-year-old man presented with chronic abdominal pain, intermittent fever, cough, diaphoresis, nausea, and rapid weight loss. Findings on CT scans showed thickening and malignant lesions in the intestine, further evaluated through laparotomy, in addition to pulmonary involvement. Jejunal perforation and septic shock were identified and treated with antibiotics. The clinical course was unfavorable, resulting in death. Peritoneal liquid cultures and hemocultures were negative, but the biopsy histological analysis revealed the presence of intracellular yeasts compatible with Histoplasma spp. This case highlights the importance of considering invasive fungal infections in apparently immunocompetent critically ill patients and reassessing diagnostic methods to ensure timely and effective treatment.