Histoplasmosis limited to the colon in a patient with systemic lupus erythematosus

Abstract

Histoplasmosis is a systemic fungal infection caused by the inhalation of microconidia of the dimorphic fungus Histoplasma capsulatum. Extrapulmonary progression of this condition is common in immunocompromised people, with the gastrointestinal system being one of the main sites of anatomical dissemination. However, isolated gastrointestinal histoplasmosis without an initial pulmonary site is highly unusual. We present the case of a 24-year-old patient with a history of
difficult-to-treat systemic lupus erythematosus who required high corticosteroid doses for several months, and who debuted with an acute episode of ulcerative colitis due to Histoplasma capsulatum, with no involvement of any other organ or anatomical site. It was therefore diagnosed as a case of histoplasmosis limited to the colon, with the fungal infection being challenging to control in the context of an immunocompromised patient.