Colonic Histoplasmosis Associated With Acquired Immunodeficiency Syndrome

We report a case involving a 46-year-old Hispanic man with a diagnosis of acquired immunodeficiency syndrome according to the Centers for Disease Control criterion of a CD4 cell count less than 0.20x10⁹/L.¹ He presented with a 3-week history of anorexia, fever (>38.8°C), sweats, diarrhea, and initially diffuse abdominal pain, which intensified postprandially. The pain localized to the right lower quadrant without rebound tenderness. Initial stool sample studies disclosed enteropathogenic Escherichia coli. Treatment with ciprofloxacin resolved the diarrhea, but systemic systems persisted and there was the appearance of a mass in the right lower quadrant on the results of a physical examination. A computed tomographic scan of the abdomen and pelvis demonstrated an appendicular and cecal mass. Subsequently, the results of an exploratory laparotomy indicated a cecal mass with a normal appendix, and a right hemicolectomy was performed. A pathologic specimen of the resected mass indicated budding yeast