Cure8 research brief
Opportunistic infections like histoplasmosis can mimic Crohn's flares or cancer in immunosuppressed patients; missing them can delay appropriate antifungal treatment.
Adults with Crohn's disease, especially patients on biologic immunosuppression; gastroenterologists, pathologists, and clinicians managing IBD; caregivers of immunosuppressed patients.
A 50-year-old woman with a 10-year history of Crohn's disease on a tumor necrosis factor (anti-TNF) inhibitor and an interleukin-23 antagonist presented with abdominal pain, diarrhea, and colonic masses. Biopsies with special fungal stain (Grocott) and immunohistochemistry showed intracytoplasmic budding yeasts; Histoplasma capsulatum was confirmed by PCR.
Standard urinary galactomannan antigen testing was negative while serum 1,3 β-D-glucan was positive. The patient was treated with amphotericin B followed by itraconazole and recovered clinically. Retrospective travel to Ecuador was identified as a possible exposure.
Next steps and practical points: In people with IBD who are immunosuppressed and present with new masses or refractory symptoms, clinicians may consider infectious causes including fungal pathogens. Communication with pathologists to request fungal stains and molecular testing can be important.
Antifungal therapy (amphotericin then itraconazole) was used successfully in this report.
This is a single case report (abstract-level content). Travel history and immunosuppression were important clues. Not all diagnostic tests are always positive (urinary antigen was negative here), so multiple diagnostic methods may be needed.
Review the original publication for the complete reporting, methods, and context.
This Cure8 brief is based on source text from the linked article. Cure8 is informational only and is not a substitute for professional medical advice, diagnosis, or treatment.
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