Case Report
Copyright ©The Author(s) 2022.
World J Gastrointest Endosc. Oct 16, 2022; 14(10): 648-656
Published online Oct 16, 2022. doi: 10.4253/wjge.v14.i10.648
Table 1 Reports of histoplasmosis mimicking inflammatory bowel disease in pediatric immunocompetent patients: Cases published between 1970–present (including current case)
No. of cases
Clinical presentation
Initial concern
Immune status
Laboratory investigations
Soper et al[23], 1970215/MPeriumbilical pain with radiation to back; prior exposure to Coccidioides and HistoplasmaPresumed CDImmunocompetentHistoplasma antibody titers 1:1024
13/MAbd pain, bilious vomiting, weight loss, fever; prior exposure to HistoplasmaPresumed CDImmunocompetentNot performed
Alberti-Flor and Granda[18], 1986116/MAbd pain, diarrhea, weakness, fever; history of Job syndromePresumed CDHyper-IgE syndromeComplement fixation 1:64; yeast antigen 1:8; preciptin (H/M bands), GMS+ yeast forms (resection specimen)
Steiner et al[19], 2009114/FFatigue, abd pain, fever, weight lossPresumed CDHyper-IgE syndromeUrine 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], 201517/FIntermittent fever and chills, weight lossPresumed CDImmunocompetentYeast forms (peripheral blood), GMS/PAS+ yeast forms (bone marrow)
Kweyamba et al[21], 201614/MIntermittent vague abd pain, anorexia, occasional vomiting and nausea; obstructing mesenteric chylous cystIntestinal obstructionImmunocompetentPAS+ yeast forms (cyst lining)
Acharyya et al[22], 202118/MColicky abd pain, weight loss, constipation, subsequent ileal stricture Presumed intestinal tuberculsosis, unresponsive to antitubercular medication × 9 moImmunocompetent GMS+ yeast forms (ileum, mesenteric nodes)
Current case, 2022112/MAbdominal pain × several months, weight loss, bloody diarrheaPresumed CDImmunocompetentGMS+ yeast forms (colon)
Table 2 Infectious mimics of inflammatory bowel disease1
Infectious etiology
Gastrointestinal site
Routine stain
Ancillary stain(s)
E. coli, O157-H7[24]Colon H&E stainGram stain
Shigella spp.[25]Colon
Salmonella spp.[26]Colon, terminal ileum
Campylobacter spp.[27]Colon, terminal ileum
Yersinia enterocolitica[28]Colon, terminal ileum
Clostridiodes difficle[29]Colon
Nesisseria gonorrhoeae[30]Colorectal
Treponema pallidum[31]Colorectal
Chlamydia trachomatis[32]Colorectal
Aeromonas spp.[33]Colon
Mycobacterial tuberculosis[34]Gastrointestinal tract, mostly terminal ileumGram stain
Acid-fast stain (Ziehl-Neelsen or Kinyoun)
Cryptococcus spp.[35]Terminal ileumH&E stainGMS stain
Histoplasma capsulatum[36]Terminal ileumPAS stain
Coccidioides spp.[37]Colon
Paracoccidioides spp.[38]Colorectal
Cytomegalovirus[39]JejunoilealH&E stainCMV immunostain
Herpes simplex virus[40]ColorectalHSV I/II immunostain
Entamoeba histolytica[41]ColonH&E stainGiemsa stain
Enterobius vermicularis[42]ColorectalSerology
Taenia saginata[43]IleumStool examination
Strongyloides stercoralis[44]Colon
Anisakis spp.[45]Ileum
Hookworm (Ancylostoma duodenale, Necator americanus)[46]Jejunoileal