{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:10:17Z","timestamp":1772496617186,"version":"3.50.1"},"reference-count":13,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,7,31]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>The clinical presentation of gastrointestinal histoplasmosis (GIH) is often non-specific, mimicking several other gastrointestinal diseases, making diagnosis difficult. We present a case of GIH, causing bowel obstruction in an immunocompetent patient. A woman in her 80s presented with anorexia and a distended abdomen. A CT scan of the abdomen and pelvis (CTAP) showed ileal thickening. Endoscopy was performed and ileal biopsies were taken. A diagnosis of histoplasmosis was made by histopathology, and she began treatment with liposomal amphotericin and itraconazole. Despite presenting well at her routine follow-up appointments, she presented 4\u2009months after diagnosis with worsening symptoms of anorexia and abdominal distention. CTAP showed the ileal stricture causing bowel obstruction. She underwent itraconazole and steroid treatment while having nasogastric tube decompression. Subsequent gastrografin follow through showing partial obstruction and surgical resection was planned. Unfortunately, her condition deteriorated, her kidney function worsened and she suffered from aspiration pneumonia with eventual demise.<\/jats:p>","DOI":"10.1136\/bcr-2023-255349","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T13:16:02Z","timestamp":1691673362000},"page":"e255349","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Gastrointestinal histoplasmosis presenting as a small bowel obstruction in an immunocompetent patient"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1810-5906","authenticated-orcid":false,"given":"Jessica","family":"Wynn","sequence":"first","affiliation":[{"name":"Department of General Surgery, Western Health, Footscray, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Western Health, Footscray, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin MC","family":"Yeung","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Western Health, Footscray, Victoria, Australia"},{"name":"Department of Surgery, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4610-6858","authenticated-orcid":false,"given":"Samantha Ann","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Western Health, Footscray, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"key":"2025082622393677000_16.8.e255349.1","doi-asserted-by":"crossref","first-page":"115","DOI":"10.9734\/jammr\/2021\/v33i330825","article-title":"Disseminated Histoplasmosis; a threat in advanced HIV disease population in sub-Saharan Africa","volume":"33","author":"Mandengue","year":"2021","journal-title":"JAMMR"},{"key":"2025082622393677000_16.8.e255349.2","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.76.896.367"},{"key":"2025082622393677000_16.8.e255349.3","doi-asserted-by":"crossref","first-page":"S1259","DOI":"10.14309\/01.ajg.0000785732.32168.de","article-title":"Obstructive Histoplasmosis resulting in recurrent nausea and vomiting","volume":"116","author":"Gnecco","year":"2021","journal-title":"Am J Gastroenterol"},{"key":"2025082622393677000_16.8.e255349.4","doi-asserted-by":"crossref","first-page":"S1080","DOI":"10.14309\/01.ajg.0000710284.82769.46","article-title":"Endoscopic balloon dilation gives durable relief of an obstruction in the terminal ileum from disseminated Histoplasmosis","volume":"115","author":"Brown","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"2025082622393677000_16.8.e255349.5","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1007\/s12328-018-0817-9","article-title":"Gastrointestinal Histoplasmosis Ileal Stricture successfully treated with through-the-scope balloon dilation in a patient with Hyperimmunoglobulin M syndrome","volume":"11","author":"Nehme","year":"2018","journal-title":"Clin J Gastroenterol"},{"key":"2025082622393677000_16.8.e255349.6","article-title":"An HIV-positive patient with disseminated Histoplasmosis complicated by Histoplasma Ileitis-induced small bowel obstruction","volume":"13","author":"Lee","year":"2021","journal-title":"Cureus"},{"key":"2025082622393677000_16.8.e255349.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2006.01.015"},{"key":"2025082622393677000_16.8.e255349.8","doi-asserted-by":"crossref","first-page":"689","DOI":"10.3390\/life13030689","article-title":"Gastrointestinal Histoplasmosis: A descriptive review, 2001\u20132021","volume":"13","author":"Ekeng","year":"2023","journal-title":"Life"},{"key":"2025082622393677000_16.8.e255349.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.40823.x"},{"key":"2025082622393677000_16.8.e255349.10","doi-asserted-by":"publisher","DOI":"10.1086\/521259"},{"key":"2025082622393677000_16.8.e255349.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2710.2005.00632.x"},{"key":"2025082622393677000_16.8.e255349.12","doi-asserted-by":"crossref","first-page":"S855","DOI":"10.14309\/01.ajg.0000708712.78856.80","article-title":"Two unusual manifestations of gastrointestinal Histoplasmosis","volume":"115","author":"Patel","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"2025082622393677000_16.8.e255349.13","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/8923972","article-title":"Gastrointestinal Histoplasmosis presenting as an acute abdomen with jejunal Perforation","volume":"2018","author":"Anderson","year":"2018","journal-title":"Case Rep Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-255349","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:39:44Z","timestamp":1756273184000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-255349"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":13,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8,10]]},"published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1136\/bcr-2023-255349"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-255349","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8]]}}}