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Open AccessFeature PaperCase Report
Diseases 2017, 5(4), 30; https://doi.org/10.3390/diseases5040030

Histoplasma and Cytomegalovirus Coinfection of the Gastrointestinal Tract in a Patient with AIDS: A Case Report and Review of the Literature

1
Division of Infectious Diseases, Department of Medicine, University of Miami, Miller School of Medicine. Miami, FL 33136, USA
2
Gilead Sciences, Miami, FL 33136, USA
*
Author to whom correspondence should be addressed.
Received: 22 November 2017 / Revised: 5 December 2017 / Accepted: 6 December 2017 / Published: 8 December 2017
(This article belongs to the Section Infectious Disease)
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Abstract

Opportunistic infections of the gastrointestinal tract are well-documented complications of patients with acquired immunodeficiency syndrome (AIDS). However, concomitant infection by Histoplasma and cytomegalovirus has been described rarely. We present the case of an HIV patient with a CD4 count of 20 cells/uL who was admitted with odynophagia and weight loss. Endoscopic evaluation revealed ulcerations in the esophagus and colon, and a mass formation in cecum. Histology revealed budding yeasts in the cecum and a transverse colon consistent with Histoplasma. Urine Histoplasma antigen was positive. Esophageal tissue disclosed viral cytopathic changes. Immunostaining was positive for cytomegalovirus in the esophagus and transverse colon. The patient was started on appropriate antifungal and antiviral treatment with complete resolution of his symptoms. To our knowledge, this is the fifth case of Histoplasma and cytomegalovirus co-infection of the gastrointestinal tract in a patient with AIDS. We also review the literature for similar cases in regards to clinical presentation and the type of gastrointestinal involvement. View Full-Text
Keywords: Histoplasma; cytomegalovirus; gastrointestinal tract; HIV; AIDS Histoplasma; cytomegalovirus; gastrointestinal tract; HIV; AIDS
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Gonzales Zamora, J.A.; Espinoza, L.A. Histoplasma and Cytomegalovirus Coinfection of the Gastrointestinal Tract in a Patient with AIDS: A Case Report and Review of the Literature. Diseases 2017, 5, 30.

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