PDF(Pubmed)
Abstract：
Histoplasmosis is a fungal infection most frequently seen in immunocompromised patients. It is endemic in Central and South America and in Africa. The infection is usually asymptomatic in a healthy individual. Extrapulmonary dissemination can be seen in immunocompromised hosts. Gastrointestinal manifestations frequently involve the terminal ileum and cecum, mimicking Crohn\'s disease or malignancy. We describe the case of a 36-year-old healthy man from Cameroon, living in Switzerland for 13 years and without any medical nor surgical history, who presented peritonitis not responding to antibiotics. CT-scan showed bowel obstruction and signs of peritonitis. We opted for an explorative laparoscopy, which was converted to laparotomy with extensive adhesiolysis. Diagnostic of histoplasmosis was confirmed by histology and PCR analysis on biopsy. To our knowledge, this is the first described case of peritonitis as main outcome of a disseminated histoplasmosis involving the peritoneum in an immunocompetent patient.
摘要：
组织胞浆菌病是一种在免疫受损患者中最常见的真菌感染。它在中美洲和南美洲以及非洲特有。感染在健康个体中通常是无症状的。在免疫受损的宿主中可以看到肺外传播。胃肠道表现经常涉及末端回肠和盲肠，模仿克罗恩病或恶性肿瘤。我们描述了一个来自喀麦隆的36岁健康男子的案例，在瑞士生活了13年，没有任何医疗或手术史，对抗生素无反应的腹膜炎患者。CT扫描显示肠梗阻和腹膜炎征象。我们选择了探索性腹腔镜检查，因广泛的粘连溶解而转为剖腹手术。通过组织学和活检的PCR分析证实了组织胞浆菌病的诊断。据我们所知,这是首例描述的腹膜炎病例，是免疫功能正常的患者累及腹膜的播散性组织胞浆菌病的主要结局。
