Disseminated histoplasmosis diagnosed on routine outpatient endoscopy in a renal transplant patient

Abstract

A 58-year-old female with prior renal transplant on immunosuppression underwent upper endoscopy and colonoscopy to evaluate iron deficiency anemia. Her upper endoscopy appeared normal and her colonoscopy showed mild colitis in her transverse colon. Biopsies of her duodenum, taken to evaluate for celiac disease, as well as biopsies of the colitis showed intracellular yeast within histiocytes in the lamina propria consistent with disseminated histoplasmosis. This case describes a renal transplant patient with disseminated gastrointestinal histoplasmosis (GIH), which is rarely diagnosed on routine outpatient endoscopy.