19 May 2025
: Case report 
A Diagnostic Dilemma: Disseminated Histoplasmosis Presenting as a Small-Bowel Obstruction
Unusual clinical course, Challenging differential diagnosis
Nicolas Tapia Stoll
EF 1, Hasan Saleh E 2, Brittany Jackson E 2*, Aleksandra Murawska Baptista EF 2, Jana G. Al Hashash DEF 3, Justin Oring EF 4, Ravi Durvasula EF 4, Raouf Nakhleh C 5, Jami Kinnucan EF 3, Daniel Kashani AEF 2
DOI: 10.12659/AJCR.946515
Am J Case Rep 2025; 26:e946515
Table 1 List of relevant diagnostic tests performed on the patient, and their results.
| Day | Diagnostic test | Result |
|---|---|---|
| 31 | GMS Stain (Ileal tissue) | Small numerous yeast forms |
| 52 | Coccidioides IgM Antibodies | positive |
| 52 | Serum Antigen | Positive (suspected cross-reactivity with antigens) |
| 55 | PCR with BAL | Negative |
| 55 | Urine Antigen | Negative |
| 55 | Fungal Culture of BAL | Yeast growths not matching or |
| 55 | Gram Stain on BAL | Negative |
| 68 | Urine Antigen | Negative |
| 68 | Fungal Culture on Sputum | Yeast growths not matching or |
| 68 | Gram Staining on Sputum | Growths Indicative of |
| 69 | Serum Antigen | Positive |
| 72 | Serum Antigen | Positive |
| 88 | Urine Antigen | Negative |
| 96 | Broad Range PCR + Sequencing (Ileal tissue) | Positive |
| 96 | GMS Stain (Ileal tissue) | Numerous yeast organisms consistent with |
| 96 | PCR (Ileal tissue) | Negative |