Disseminated histoplasmosis with gastrointestinal involvement in a patient with HIV: Case report and systematic review of the literature.

Disseminated histoplasmosis is a life-threatening opportunistic infection in patients with advanced HIV. We report the case of a 43-year-old man with untreated HIV who presented with disseminated histoplasmosis and gastrointestinal involvement, including recurrent intestinal obstruction. Follow-up revealed colonic auto-amputation, a previously unreported complication. A systematic review of the literature was conducted following PRISMA guidelines. Most reported cases occurred in Southeast Asia and Latin America. Colonic and duodenal involvement were the most frequent gastrointestinal manifestations. CD4 counts below 200cells/mm3 were consistently associated with worse outcomes. This case highlights an exceptional complication of intestinal histoplasmosis and underscores the need for early recognition and treatment in immunocompromised patients.