Primary Abdominal Disseminated Histoplasmosis Infection in a Patient on TNF-α Inhibitor Therapy Mimicking Intestinal Carcinoma

  • Ian Parker, D.O. Georgia Campus–Philadelphia College of Osteopathic Medicine (GA-PCOM)


Histoplasmosis capsulatum is a dimorphic fungus often associated with opportunistic infections in immunocompromised patients. Many patients who take immunosuppressive medications for chronic inflammatory conditions are at increased susceptibility for Histoplasmosis infections. Pulmonary infection is the most common form of Histoplasmosis infection; with risk for dissemination in immunosuppressed populations (1-5). This unique case involves a 68 year old female from eastern Oklahoma with a 15-year history of Rheumatoid Arthritis treated with infliximab and leflunomide who developed an atypical presentation of disseminated Histoplasmosis. Her initial symptoms of abdominal pain and weight loss mimicked an abdominal malignancy, however further examination revealed Histoplasmosis infection which responded to surgery and antifungal therapy.