title: [Colonic histoplasmosis as a diagnostic manifestation of AIDS].
abstract: We report the case of 48 year old female patient without a history of significance importance.(refuses blood transfusion). She complaint of diarrhea of four months of duration and weight loss of 8 kg. she added episodes of hematochezia and severe anemia requiring transfusion. An intrahemorrhagic colonoscopy was performed detecting three ulcerated lesions. First at 10 cm from the anus, one in transverse colon distal, another similar ulcer in the proximal transverse The biopsies showed ulcer granulation tissue, abundant macrophages with intracytoplasmic structures consistent with histoplasmosis. Tests showed no tuberculosis or intestinal parasitosis. HIV testing (ELISA and Western Blot) were positive. The CD4 (78 cells) and extrapulmonary histoplasmosis were the criteria defined stage AIDS. The extrapulmonary histoplasmosis defines stage IV in immunosuppressed patients with HIV. Lower gastrointestinal bleeding colonic ulcer secondary to Histoplasma is a rare form presentation as a diagnostic manifestation of AIDS.
authors.affiliation: Departamento Del Aparato Digestivo, Hospital Nacional Edgardo Rebagliati Martins, EsSALUD, Lima, Perù. alva.edgar@gmail.com
authors.forename: Edgar
authors.initials: E
authors.lastname: Alva
authors.forename: Jorge
authors.initials: J
authors.lastname: Vásquez
authors.forename: Oscar
authors.initials: O
authors.lastname: Frisancho
authors.forename: Max
authors.initials: M
authors.lastname: Yoza
authors.forename: Alejandro
authors.initials: A
authors.lastname: Yábar
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000382:microbiology*; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003108:Colonic Diseases / Q000188:drug therapy / Q000209:etiology*; D003113:Colonoscopy; D004359:Drug Therapy, Combination; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006679:HIV Seropositivity / Q000175:diagnosis*; D006660:Histoplasmosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008264:Macrophages / Q000382:microbiology; D008875:Middle Aged; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000627:therapeutic use; D014456:Ulcer / Q000209:etiology / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D015662:Trimethoprim, Sulfamethoxazole Drug Combination