Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2022; 14(10): 648-656
Published online Oct 16, 2022. doi: 10.4253/wjge.v14.i10.648
Gastrointestinal histoplasmosis complicating pediatric Crohn disease: A case report and review of literature
C Quinn Miller, Omer A M Saeed, Katrina Collins
C Quinn Miller, Omer A M Saeed, Katrina Collins, Department of Pathology, Indiana University School of Medicine, Indianapolis, IN 46202, United States
Author contributions: Miller CQ served as the primary author; Miller CQ and Collins K are responsible for this literature review; Miller CQ, Saeed OAM, and Collins K were responsible in the construction of the manuscript; Collins K served as the senior author, provided invaluable educational input and managed the edits of the manuscript, and guided the primary author through the submission process; All authors read, revised, and gave approval of the manuscript.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Katrina Collins, MD, Assistant Professor, Department of Pathology, Indiana University School of Medicine, 350 W 11th Street, Indianapolis, IN 46202, United States.
Received: July 17, 2022
Peer-review started: July 17, 2022
First decision: September 5, 2022
Revised: September 5, 2022
Accepted: September 21, 2022
Article in press: September 21, 2022
Published online: October 16, 2022
Core Tip

Core Tip: Impaired cell-mediated immunity is known to increase the risk for disseminated histoplasmosis and has been described in the setting of Crohn disease (CD) treated with immunosuppressant agents. Endoscopically, the appearance of histoplasmosis varies and includes features of inflammatory mucosal changes. Increasing awareness of this condition is critical to avoid misdiagnosis and inappropriate treatment, particularly in the setting of underlying CD. While no specific recommendations are available, immunosuppressive therapy may be safely initiated in some cases when there appears to be effective response to antifungal therapy and the patient can be monitored closely.