GASTROINTESTINAL HISTOPLASMOSIS IN A PATIENT FROM GUADELOUPE WITH AIDS

The authors report the case of a 45-year-old HIV and HTLV1 antibody positive male patient form French West-Indies who was infected by disseminated histoplasmosis presenting as acute diarrhea. Esophagogastroduodenoscopy revealed gastric mass and colonoscopy patchy erythematous mucosa. The diagnosis was made by histology of bone marrow specimens, upper gastrointestinal tract and colon biopsies, and late skin lesions. Initial therapy with amphotericin B and itraconazole was successful, but maintenance therapy with itraconazole alone did not prevent relapse and a fatal outcome. Disseminated histoplasmosis in AIDS patients may be present as gastrointestinal manifestations and should be kept in mind in non endemic areas such as the French West Indies.