Intestinal histoplasmosis in AIDS patients: report of three cases observed in France and review of the literature.
We report three cases of colonic histoplasmosis observed in a non-endemic area in patients with AIDS. The patients presented with fever, abdominal pain and an abdominal mass in the right lower quadrant. Diagnosis was obtained using Gomori-Crocott staining of endoscopic or surgical biopsies. One patient died without specific treatment and two patients had a complete remission when treated with intravenous amphotericin B but suffered a relapse when given oral itraconazole. Thus, physicians in areas where intestinal histoplasmosis is not endemic should be aware of the condition. Diagnosis can easily be obtained using Gomori-Crocott staining of colonoscopic biopsies; this should avoid unnecessary laparotomies and allow specific treatment to be instituted rapidly.
Trylesinski
A
A
Service de Gastroentérologie et de Nutrition, Hôpital Rothschild, Paris, France.
Carbonnel
F
F
Bouchaud
O
O
Beaugerie
L
L
Gharakanian
S
S
Rozenbaum
W
W
Cosnes
J
J
Gendre
J P
JP
Le Quintrec
Y
Y
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003108:Colonic Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006660:Histoplasmosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male
D000935:Antifungal Agents; D000666:Amphotericin B