Presentation and Treatment for Intestinal Histoplasmosis
Location
D.P. Culp Center Ballroom
Start Date
4-5-2024 9:00 AM
End Date
4-5-2024 11:30 AM
Poster Number
93
Name of Project's Faculty Sponsor
Erin Hood
Faculty Sponsor's Department
Internal Medicine
Competition Type
Competitive
Type
Poster Presentation
Presentation Category
Health
Abstract or Artist's Statement
Intestinal histoplasmosis is a rare condition caused by Histoplasma Caspulatum typically associated with disseminated disease in immunosuppressed patients. Histoplasmosa Caspulatum is a thermally dimorphic microconidia spore that is endemic to the Ohio and Mississippi River Valleys. It is classically transmitted through bat and bird feces. The spores in the feces are inhaled and travel to alveoli where they are phagocytosed by alveolar macrophages. The macrophages then divide against T cell mediated immunity and invade surrounding regional hilar lymph nodes. This can lead to systemic infection which is seen in 3-12% of cases and has been found to develop up to 20 years after initial diagnostic workup. The disseminated infection can spread to any organ system, but has a high probability of gastrointestinal invasion. This case involved a 19-year-old female who lived on a farm that presented with dyspnea and recurrent diarrhea. She was also immunocompromised due to relapsing polychondritis. Her initial chest X-ray showed bilateral interstitial and airspace infiltrates most pronounced in the base of the lungs, and peripheral smear confirmed histoplasmosis. After a colonoscopy was performed, a biopsy was taken and was also positive for histoplasmosis. The patient was initially started on Amphotericin B and switched to Itraconazole. Three months following therapy, the patient appeared to be responding well to treatment with symptomatic improvement. This case illustrates how disseminated histoplasmosis can lead to gastrointestinal invasion, how it can present, and how treatment can be effective.
Presentation and Treatment for Intestinal Histoplasmosis
D.P. Culp Center Ballroom
Intestinal histoplasmosis is a rare condition caused by Histoplasma Caspulatum typically associated with disseminated disease in immunosuppressed patients. Histoplasmosa Caspulatum is a thermally dimorphic microconidia spore that is endemic to the Ohio and Mississippi River Valleys. It is classically transmitted through bat and bird feces. The spores in the feces are inhaled and travel to alveoli where they are phagocytosed by alveolar macrophages. The macrophages then divide against T cell mediated immunity and invade surrounding regional hilar lymph nodes. This can lead to systemic infection which is seen in 3-12% of cases and has been found to develop up to 20 years after initial diagnostic workup. The disseminated infection can spread to any organ system, but has a high probability of gastrointestinal invasion. This case involved a 19-year-old female who lived on a farm that presented with dyspnea and recurrent diarrhea. She was also immunocompromised due to relapsing polychondritis. Her initial chest X-ray showed bilateral interstitial and airspace infiltrates most pronounced in the base of the lungs, and peripheral smear confirmed histoplasmosis. After a colonoscopy was performed, a biopsy was taken and was also positive for histoplasmosis. The patient was initially started on Amphotericin B and switched to Itraconazole. Three months following therapy, the patient appeared to be responding well to treatment with symptomatic improvement. This case illustrates how disseminated histoplasmosis can lead to gastrointestinal invasion, how it can present, and how treatment can be effective.