Computed tomography for the diagnosis of HIV-associated gastro-intestinal histoplasmosis

Abstract

Introduction

Disseminated histoplasmosis is one of the leading opportunistic infections among people living with human immunodeficiency virus (PLHIV) in Latin America. Intestinal involvement is common, but its computed tomography findings have not been properly described. We aimed to provide a computed tomography description of histoplasmosis intestinal involvement.

Patients and methods

We performed a retrospective observational study of patients with disseminated histoplasmosis and proven intestinal involvement.

Results

A total of 18 patients with an available contrast-enhanced abdominal computed tomography (8 women, mean age 44 years) were included. Seventeen had intestinal parietal thickening (94 %), with a mean thickening of 14  mm, unifocal or multifocal, frequently circumferential (71 %). The most commonly affected segments were the cecum and right colon in 13/17 (76 %) of patients each. Adenomegaly was constant, mostly homogeneous.

Conclusion

These computed tomography features in patients with advanced HIV disease may be key findings for an early diagnosis in the absence of proven histoplasmosis.