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Introduction: Histoplasmosis is a common opportunistic infection in areas where it is endemic as Panama. It is usually a late manifestation of an infection with HIV, however in some cases it may be the definitive initial state of AIDS. The commitment of gastrointestinal infection can manifest itself in several ways, such as diarrhea, chronic inflammation, including in the differential diagnosis a Histoplasma infection.
Case Report: We report the a case of a 70 year-old man, that showed up to the emergency room with a history of 4 months of evolution, characterized by bloody diarrhea, weight loss and intermittent fever. The physical examination revealed stable vital signs, hepatomegaly, diffuse abdominal pain and bloody stool in the rectal ampulla. During the evaluation it is determined that he presented an infection with HIV, and the initial examination of stool did not reveal the cause of diarrhea. It is proceeded to study the colon with endoscopic biopsy, which revealed mucosal inflammation with ulcers and the presence of spores consistent with Histoplasma capsulatum in the biopsy.
Conclusion: We have a patient whose initial manifestation of infection with HIV was one of infectious colitis by Histoplasma capsulatum, which is definitely suggestive of AIDS. He received treatment with Amphotericin B and Itraconazole in addition to antiretroviral therapy.
