Gastrointestinal histoplasmosis complicating pediatric Crohn disease: A case report and review of literature

Table 1 Reports of histoplasmosis mimicking inflammatory bowel disease in pediatric immunocompetent patients: Cases published between 1970–present (including current case)

Ref.	No. of cases	Age/Sex	Clinical presentation	Initial concern	Immune status	Laboratory investigations
Soper et al[23], 1970	2	15/M	Periumbilical pain with radiation to back; prior exposure to Coccidioides and Histoplasma	Presumed CD	Immunocompetent	Histoplasma antibody titers 1:1024
		13/M	Abd pain, bilious vomiting, weight loss, fever; prior exposure to Histoplasma	Presumed CD	Immunocompetent	Not performed
Alberti-Flor and Granda[18], 1986	1	16/M	Abd pain, diarrhea, weakness, fever; history of Job syndrome	Presumed CD	Hyper-IgE syndrome	Complement fixation 1:64; yeast antigen 1:8; preciptin (H/M bands), GMS+ yeast forms (resection specimen)
Steiner et al[19], 2009	1	14/F	Fatigue, abd pain, fever, weight loss	Presumed CD	Hyper-IgE syndrome	Urine Histoplasma antigen (8.34 ng/mL), Histoplasma complement fixation titers 1:32 (mycelial phase) 1:64 (yeast phase), preciptin (H/M bands), Yeast forms (terminal ileum, ileocecal valve)
Agarwal et al[20], 2015	1	7/F	Intermittent fever and chills, weight loss	Presumed CD	Immunocompetent	Yeast forms (peripheral blood), GMS/PAS+ yeast forms (bone marrow)
Kweyamba et al[21], 2016	1	4/M	Intermittent vague abd pain, anorexia, occasional vomiting and nausea; obstructing mesenteric chylous cyst	Intestinal obstruction	Immunocompetent	PAS+ yeast forms (cyst lining)
Acharyya et al[22], 2021	1	8/M	Colicky abd pain, weight loss, constipation, subsequent ileal stricture	Presumed intestinal tuberculsosis, unresponsive to antitubercular medication × 9 mo	Immunocompetent	GMS+ yeast forms (ileum, mesenteric nodes)
Current case, 2022	1	12/M	Abdominal pain × several months, weight loss, bloody diarrhea	Presumed CD	Immunocompetent	GMS+ yeast forms (colon)

6-MP: 6-mercaptopurine; abd: Abdominal; CD: Crohn disease; GI: Gastrointestinal; IBD: Inflammatory bowel disease; NR: Not reported; UC: Ulcerative colitis.