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Disseminated Histoplasmosis and Miliary Tuberculosis Imitating Colon Cancer in Patient with HIV Who Refuses to Antirretroviral Treatment

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Abstract

Simultaneous infection with histoplasmosis and miliary tuberculosis is rare and mainly affects people with severe immunosuppression, they can present very diverse clinical forms, similar to other infectious and neoplastic pathologies. We present the case of a 27-year-old woman diagnosed with HIV infection for 08 years who refuses to receive antiretroviral treatment (ART) and conceals her diagnosis, comes to the Hospital for pain, abdominal distension and ulcer in the oral cavity. The patient was diagnosed with likely cancer by presenting irregular intestinal thickening with homogeneous gray pattern in colon tomography and signs of intestinal obstruction, that after hemicolectomy was evidenced histoplasmosis in the pathological study, during the treatment with amphotericin B deoxycholate and improvement of the oral ulcer, the patient presented dyspnea, micronodular pattern on the chest radiograph that had not previously existed and the lipoarabinomanan antigen in the urine was positive for tuberculosis. In immunosuppressed patients, intestinal histoplasma infection may have clinical and tomographic characteristics similar to colon cáncer.

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Authors and Affiliations

  1. Facultad de Medicina, Universidad Nacional del Centro del Perú, Avenue Mariscal Castilla 3909, 1206, Huancayo, Perú

    Raúl Montalvo, Gisel Pomalaza & Jocelyn Quispe

  2. Servicio de Patología, Hospital Daniel Alcides Carrión, Huancayo, Perú

    Magaly Sandoval

Authors
  1. Raúl Montalvo
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  2. Gisel Pomalaza
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  3. Magaly Sandoval
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  4. Jocelyn Quispe
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Correspondence to Raúl Montalvo.

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The authors hereby certify that there is no conflict of interest regarding the publication of this paper. It has been written taking into account the checklist implemented by Mycopathologia to ensure consistency and quality across case reports [15].

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Montalvo, R., Pomalaza, G., Sandoval, M. et al. Disseminated Histoplasmosis and Miliary Tuberculosis Imitating Colon Cancer in Patient with HIV Who Refuses to Antirretroviral Treatment. Mycopathologia 185, 583–586 (2020). https://doi.org/10.1007/s11046-020-00437-w

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  • DOI: https://doi.org/10.1007/s11046-020-00437-w

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