Keywords
anal histoplasmosis
opportunistic diseases
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Abstract
Objective: To report a case of a patient diagnosed with anorectal histoplasmosis and carrier of the acquired immunodeficiency virus. Case details: Female patient aged 37 years and carrying the human immunodeficiency virus for 10 years under irregular treatment, complaining of purulent secretion and blood coming out of the anus, associated with intense pain for 2 months and weight loss of approximately 40 kilograms in the same period. During rectal examination, there was evident hypotonia of the anal sphincter, with the presence of a circumferential vegetative lesion, which began in the anal canal and extended to the lower rectum; presence of mucus and blood on a glove finger. A biopsy of the described lesion was performed, which revealed in the anatomopathological examination the presence of oval fungal structures morphologically compatible with Histoplasma capsulatum. Final considerations: Histoplasmosis is an opportunistic infection that commonly presents in disseminated form in immunosuppressed patients. In this reported case, localized histoplasmosis was evidenced through an anal lesion, which can also mimic other diagnoses such as carcinoma. This emphasizes the importance of clinical reasoning associated with the patient’s comorbidities to evaluate diagnostic possibilities in immunosuppressed patients with anal injuries.
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