Open AccessEsophageal histoplasmosis in a renal allograft recipient
Author(s) -
Laveena Sharma,
J Falodia,
Komal Kalla,
Mukesh Kalla,
Jugal Behari Gupta,
Shreyash Gupta,
Pankaj Beniwal,
Mahaveer Singh,
Vinay Malhotra,
Deepak Agarwal
Publication year - 2013
Publication title -
saudi journal of kidney diseases and transplantation/našrat amraḍ wa zira'aẗ al-kulaẗ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.268
H-Index - 30
eISSN - 2320-3838
pISSN - 1319-2442
DOI - 10.4103/1319-2442.113874
Subject(s) - medicine , histoplasmosis , histoplasma , dysphagia , itraconazole , histoplasma capsulatum , dimorphic fungus , biopsy , mycosis , esophageal candidiasis , surgery , pathology , dermatology , immunology , antifungal , human immunodeficiency virus (hiv) , genetics , biology , viral disease , yeast
Histoplasmosis is a progressive granulomatous disease caused by the intracellular dimorphic fungus Histoplasma capsulatum. We report a rare case of esophageal histoplasmosis in a renal allograft recipient. A 55-year-old male who received a live, unrelated renal allograft 20 years ago presented with complaints of recurrent fever for ten to 12 months, weight loss over six months, progressive dysphagia more for solids for five to six months and joint pain and swelling involving the bilateral metacarpo-phalangeal and proximal interphalangeal joints. Biopsy from the esophageal ulcers revealed dense inflammation infiltrated with lymphocytes and macrophages with clusters of strongly positive intracellular fungal spores with a clear area or "halo-like" zone suggestive of Histoplasma capsulatum invasion. The patient was treated with intravenous liposomal amphotericin B for ten days and later switched over to oral itraconazole. Repeated endoscopy revealed significant improvement of the lesions