Disseminated histoplasmosis presenting as a gastric ulcer

Although fungi, including Histoplasma capsulatum, are known to cause gastric ulcers in patients who reside in areas in which the fungi are endemic, such lesions are relatively uncommon and less recognized in patients who live outside such areas. Nonetheless, histoplasmosis should be considered in the differential diagnosis of gastric ulcer with granulomatous inflammation in immunocompromised patients. Repeated biopsies may be needed to identify the organism in some patients.