Intestinal occlusion of jejunum

Exceptional presentation of histoplasmosis and HIV infection

Authors

  • Nikolás Franco Universidad de la República, Facultad de Medicina, Clínica Quirúrgica "3", Residente de Cirugía
  • Olivier Bertaux Universidad de la República, Facultad de Medicina, Residente de Terapia Intensiva
  • Gustavo Sánchez Universidad de la República, Facultad de Medicina, Clínica Quirúrgica "2", Residente de Cirugía
  • Mariela Rondan Universidad de la República, Facultad de Medicina, Hospital Maciel, Servicio de Anatomía Patológica, Jefa
  • Gustavo Rodríguez Universidad de la República, Facultad de Medicina, Clínica Quirúrgica "3", Profesor Agregado
  • Luis Ruso Universidad de la República, Facultad de Medicina, Clínica Quirúrgica "3", Profesor Titular de Cirugía

Keywords:

HISTOPLASMOSIS, HISTOPLASM, INTESTINAL OBSTRUCTION, JEJUNUM, HIV INFECTIONS

Abstract

Histoplasma capsulatum is a widespread fungus of aereal infectation. Clinically presented as bronchopneumonia, it has been lately associated with compromised immune system, specially HIV. The affectation at digestive tract level is rare but shows that dissemination is systemic; patients presenting symptomatic digestive infection, diagnosis of AIDS is clear for patients with HIV.
An exceptional clinical case of jejunum intestinal occlusion caused by an anular area of stenosis in a young women with uncertain intra-operatory diagnosis and histopathologic diagnosis of histoplasma capsulatum without previous notice of HIV infection nor respiratory compromise is presented.

References

(1) Deepe GS Jr. Histoplasma cpsulatum. In: Mandell G, Bennett J, Dolin R, eds. Principles and practice of infectious diseases. 6 ed. Philadelphia: Elsevier, 2005: 3012-26.
(2) Pérez C, Sturim H, Konchonkos N, Kamberg S. Some clinical and radiographic features of gastrointestinal histoplasmosis. Radiology 1966; 86(3): 482-7.
(3) Strim HS, Konchonkos NT, Ahalvin RC. Gastrointestinal manifestations of disseminated histoplasmosis. Am J Surg 1965; 110: 435-40.
(4) Mohanty SK, Reddy P, Polk JW. Acute small bowel obstructions from disseminated Histoplasmosis. Case report. Mo Med 1970; 67(2): 100-3.
(5) Hertan H, Nair S, Arguello P. Progresive gastrointestinal histoplasmosis leading to colonic obstruction two years after initial presentation. Am J Gastroenterol 2001; 96(1): 221-2.
(6) Gumbs M, Girishkumar H, Yousuf A, Levy L, Patel M, Narasimha V. Histoplasmosis of the small bowel in patient with AIDS. Postgrad Med J 2000; 76: 367-9.
(7) Cimponeriu D, LoPresti P, Lavalanet M, Roistacher K, Remigio P, Marfatia S, et al. Gastrointestinal histoplasmosis in HIV infection: two cases of colonic pseudocancer and review of literature. Am J Gastroenterol 1994; 89: 129-31.
(8) Darling ST. A protozoon general infection producing pseudotubercles in the lungs and focal necrosis in the liver, splen and lymphatics. JAMA 1906; 46: 1283-85.
(9) Crumrine RM, Kessel JF. Histoplasmosis (Darling) without splenomegaly. Am J Trop Med 1931; 11: 435.
(10) De Monbreun WA. The cultivation and cultural characteristics of Darlings histoplasma capsulatum. Am J Trop Med 1934; 14: 93-125.
(11) Henderson RG, Pirkerton H, Moore LT. Histoplasma capsulatum as a cause of chronic ulcerative enteritis. JAMA 1942; 118: 885-9.
(12) Parsons RJ, Zaforanetis CJ. Histoplasmosis in man: report of 7 cases and review of 71 cases. AMA Arch Intern Med 1945; 75: 1.
(13) Cappell MS, Mandel W, Gimes MM, New HC. Gastrointestinal histoplasmosis. Dig Dis Sci 1988; 33(3): 353-60.
(14) Khalil K, Iwatt AR, Gugani HC. African histoplasmosis masquerading as carcinoma of the colon. Dis Colon Rectum 1989; 32: 518-20.
(15) Suárez G, Mendivelson E, Veles J, Rojas E, Velandia F. Histoplasmosis intestinal Caso clínico. Disponible en: http://www.encolombia.com/gastro14399-histoplasmosis.htm (Consulta: 2 set 2005).
(16) AIDS Program, Center for Infectious Diseases. MMWR Morb Mortal Wkly Rep. 1987; 36 (Suppl 1): 1S-15S.
(17) Mansilla M, Purtscher H, Mirazo I, Lima E, Cardozo A, Braselli A. Evolución de 172 pacientes VIH+ fallecidos en Uruguay. Rev Med Urug 1996; 12: 123-34.
(18) Limongi G, Bagnulo H. VIH-SIDA en medicina intensiva, causas de ingreso y resultados. Congreso Panamericano de Infectología, 11. (Córdoba-Argentina, 11-14 de mayo 2003).
(19) Adekunle O, Sudhakaran P, Timeyn E. African histoplasmosis of the jejunum. J Trop Med Hyg 1978; 81(5): 89-90.

Published

2007-03-31

How to Cite

1.
Franco N, Bertaux O, Sánchez G, Rondan M, Rodríguez G, Ruso L. Intestinal occlusion of jejunum: Exceptional presentation of histoplasmosis and HIV infection. Rev. Méd. Urug. [Internet]. 2007 Mar. 31 [cited 2024 Nov. 22];23(1):64-8. Available from: https://revista.rmu.org.uy/index.php/rmu/article/view/637