Cholestasis and disseminated histoplasmosis in a psoriatic patient on infliximab: case report and review of literature.

摘要: Histoplasma capsulatum is the most common endemic mycosis in United States and frequently presents as an opportunistic infection immunocompromised hosts. Though liver involvement disseminated histoplasmosis, primary gastrointestinal histoplasmosis of absence lung rare. Similarly, cholestatic granulomatous hepatitis rarely seen. We present a rare case manifesting with acute cholestasis 48-year-old female psoriatic arthritis, receiving methotrexate infliximab. The epidemiology, risk factors, clinical presentation, diagnosis, treatment discussed. Furthermore, we review published cases biopsy-proven jaundice to highlight liver. Histoplasmosis should be considered immunosuppressed patients fever, chills, abdominal pain progressive jaundice, particularly subjects without evidence biliary obstruction. Future studies are needed accurately assess this fungal infection, specifically on immunomodulatory therapy for autoimmune disease.