{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:54:49Z","timestamp":1791273289329,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Gastrointestinal histoplasmosis is an under\u2010recognized manifestation of disseminated Histoplasma capsulatum infection. Its ileocecal predilection closely mimics intestinal tuberculosis (TB) and Crohn's disease, posing serious diagnostic challenges, particularly in TB\u2010endemic regions. A 26\u2010year\u2010old immunocompetent male presented with a 3\u2010month history of diffuse abdominal pain, hematochezia, and 16\u2009kg weight loss. He had received 60\u2009days of empirical four\u2010drug anti\u2010tubercular therapy (ATT) without improvement. Examination revealed cachexia, pallor, digital clubbing, pedal oedema, a hard palate ulcer, and small cervical lymphadenopathy. Investigations showed microcytic anemia, C\u2010reactive protein (CRP) 143.35\u2009mg\/L, hypoalbuminemia (2\u2009g\/dL), hyponatremia, and fecal calprotectin of 1849.47\u2009\u03bcg\/g. Magnetic resonance enterography (MRE) suggested multi\u2010segmental small bowel disease consistent with Crohn's disease. Sequential colonoscopies revealed ulcero\u2010nodular lesions involving the distal ileum, ileocecal valve, and caecum. Initial biopsies were inconclusive. Repeat deep tissue biopsy from the caecum and ileocecal valve identified intracellular narrow\u2010based budding yeast forms with eccentric nuclei, consistent with H. capsulatum. GeneXpert and Quantiferon\u2010TB gold plus were negative. Cervical lymph node fine\u2010needle aspiration cytology (FNAC) confirmed disseminated disease. HIV testing was negative. Itraconazole was initiated, followed by liposomal amphotericin B. On day 15, the patient developed catastrophic lower gastrointestinal hemorrhage, resulting in refractory hemodynamic collapse and death. Disseminated histoplasmosis should be considered in the differential diagnosis of ileocecal disease even in immunocompetent patients from TB\u2010endemic regions. Histopathological confirmation through deep tissue biopsy is critical prior to immunosuppressive therapy. Delayed diagnosis carries significant mortality risk.<\/jats:p>","DOI":"10.1002\/ccr3.73555","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:17:11Z","timestamp":1789705031000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gastrointestinal Histoplasmosis Mimicking Intestinal Tuberculosis and Crohn's Disease: Ileocecal Involvement in an Immunocompetent Host"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2515-3042","authenticated-orcid":false,"given":"Rashid Shahriar","family":"Sazal","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Bangladesh Medical University  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7595-0150","authenticated-orcid":false,"given":"Sayma Samia","family":"Esha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Bangladesh Medical University  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4496-8932","authenticated-orcid":false,"given":"Abdullah Al","family":"Faisal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Bangladesh Medical University  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7771-1065","authenticated-orcid":false,"given":"Md. Abul Kalam","family":"Azad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Bangladesh Medical University  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6204-0501","authenticated-orcid":false,"given":"Khaled Mahbub","family":"Murshed","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Bangladesh Medical University  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5221-0021","authenticated-orcid":false,"given":"Kazi Ali","family":"Aftab","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Bangladesh Medical University  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/521259"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40475\u2010015\u20100044\u20100"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1309\/X0Y2\u2010P3GY\u2010TWE8\u2010DM02"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.40823.x"},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","unstructured":"\u201cIleum Histoplasmosis Mimicking Intestinal Tuberculosis and Crohn's Disease | Case Reports in Gastroenterology | Karger Publishers \u201daccessed May 23 2026 https:\/\/karger.com\/crg\/article\/12\/1\/63\/87553\/Ileum\u2010Histoplasmosis\u2010Mimicking\u2010Intestinal.","DOI":"10.1159\/000480377"},{"key":"e_1_2_13_7_1","unstructured":"S.Newman \u201cCell\u2010Mediated Immunity to Histoplasma Capsulatum \u201d Seminars in Respiratory Infections 2001 accessed May 23 2026 https:\/\/www.semanticscholar.org\/paper\/Cell\u2010mediated\u2010immunity\u2010to\u2010Histoplasma\u2010capsulatum.\u2010Newman\/1cdbdcece3733f4ae89416cc5d693e95f3f4ac59."},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2021.03.011"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2006.01.015"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102334\u201013\u2010143"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.120"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab249"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.00027\u201006"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mmcr.2020.08.003"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/13693786.2011.577821"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/7139573"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73555","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73555","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73555","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:39:13Z","timestamp":1791272353000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73555"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":15,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/ccr3.73555"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73555","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-05-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73555"}}