Protein-losing enteropathy and hypogammaglobulinaemia as first manifestations of disseminated histoplasmosis coincident with Nocardia infection.
Disseminated histoplasmosis and nocardiosis typically affect immunocompromised hosts. We report a case of gastrointestinal and adrenal histoplasmosis, presenting as protein-losing enteropathy and hypogammaglobulinaemia, coincident with Nocardia infection, in a HIV-negative patient in whom a specific immunological defect could not be identified. Clinicians in areas of non-endemicity should be vigilant for rare manifestations of histoplasmosis.
Centre for Infectious Diseases and Microbiology Laboratory Services, Westmead Hospital, Westmead, NSW 2145, Australia.|Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, NSW 2145, Australia.
Jen
J
Kok
Centre for Infectious Diseases and Microbiology Laboratory Services, Westmead Hospital, Westmead, NSW 2145, Australia.|Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, NSW 2145, Australia.
Sharon C A
SCA
Chen
Department of Anatomical Pathology and Cytology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia.
Lyndal
L
Anderson
Department of Immunology, Westmead Hospital, Westmead, NSW 2145, Australia.
Lucinda
L
Berglund
Centre for Infectious Diseases and Microbiology Laboratory Services, Westmead Hospital, Westmead, NSW 2145, Australia.
Sue
S
Sleiman
Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, NSW 2145, Australia.
Alan
A
Moss
Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, NSW 2145, Australia.
Michael
M
Bourke
Department of Immunology, Westmead Hospital, Westmead, NSW 2145, Australia.
David
D
Fulcher
Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, NSW 2145, Australia.
Nicole
N
Gilroy
D000328:Adult; D000361:Agammaglobulinemia / Q000209:etiology*; D016099:Endoscopy, Gastrointestinal; D006658:Histoplasma / Q000302:isolation & purification; D006660:Histoplasmosis / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007583:Jejunum / Q000382:microbiology / Q000473:pathology; D008297:Male; D009615:Nocardia / Q000302:isolation & purification; D009617:Nocardia Infections / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D011504:Protein-Losing Enteropathies / Q000209:etiology*