Background: Infection with Histoplasma capsulatum can lead to a disseminated disease involving the gastrointestinal tract presenting as diffuse abdominal pain and inflammatory diarrhea which may mimic inflammatory bowel disease (IBD).
Case summary: In the current report, we discuss the case of a 41-year old male who presented to the emergency department with complaints of high-grade intermittent fevers and severe abdominal pain with associated diarrhea and hematochezia. Laboratory results demonstrated transaminitis and elevated erythrocyte sedimentation rate, C-reactive protein and ferritin levels. The patient's presentation was thought to be an exacerbation of his underlying IBD, but further investigations revealed a positive Histoplasma antigen in the urine. The patient was offered a colonoscopy and biopsy to confirm the diagnosis; however, he refused. He was treated with itraconazole and showed significant improvement of his symptoms, thereby confirming the diagnosis of gastrointestinal histoplasmosis.
Conclusion: Here within, we provide a review of IBD, evaluation of chronic diarrhea, and gastrointestinal histoplasmosis.
Keywords: Case report; Endoscopy; Gastroenterology; Histoplasmosis; Inflammatory bowel disease; Intestine.
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