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.
Kok
Jen
J
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.
Chen
Sharon C A
SCA
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.
Anderson
Lyndal
L
Department of Anatomical Pathology and Cytology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia.
Berglund
Lucinda
L
Department of Immunology, Westmead Hospital, Westmead, NSW 2145, Australia.
Sleiman
Sue
S
Centre for Infectious Diseases and Microbiology Laboratory Services, Westmead Hospital, Westmead, NSW 2145, Australia.
Moss
Alan
A
Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, NSW 2145, Australia.
Bourke
Michael
M
Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, NSW 2145, Australia.
Fulcher
David
D
Department of Immunology, Westmead Hospital, Westmead, NSW 2145, Australia.
Gilroy
Nicole
N
Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, NSW 2145, Australia.
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*