GASTROINTESTINAL HISTOPLASMOSIS IN A PATI ENT FROM GUADELOUPE WITH AIDS

The authors report the case of a 45-year-old HIV and HTLV1 antibody po sitive male patient form French West-Indies who was infected by dissem inated histoplasmosis presenting as acute diarrhea. Esophagogastroduod enoscopy revealed gastric mass and colonoscopy patchy erythematous muc osa. The diagnosis was made by histology of bone marrow specimens, upp er gastrointestinal tract and colon biopsies, and late skin lesions. I nitial therapy with amphotericin B and itraconazole was successful, bu t maintenance therapy with itraconazole alone did not prevent relapse and a fatal outcome. Disseminated histoplasmosis in AIDS patients may be present as gastrointestinal manifestations and should be kept in mi nd in non endemic areas such as the French West Indies.