Gastrointestinal manifestations in systemic fungal infection are not uncommon; however, obstructive jaundice due to lymphadenopathy is considered rare. We present a case of a 16-year-old male patient who presented with painless jaundice. Laboratory tests revealed direct hyperbilirubinemia with cholestatic liver injury. Chest and abdominal computed tomography showed mediastinal and porta hepatis lymphadenopathy, with severe biliary ductal dilatation proximal to an obstructing lymph node near the head of the pancreas. Endoscopic ultrasound showed a 22 × 35-mm lymph node with a mass effect on the common bile duct leading to obstructive jaundice. Infectious workup confirmed the diagnosis of disseminated histoplasmosis.
Keywords: ERCP; endoscopic ultrasound; histoplasmosis; lymphadenopathy; obstructive jaundice.
© 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.