Massive gastrointestinal bleeding in AIDS patients secondary to histoplasma and cytomegalovirus infection

• Gastrointestinal CMV infection in the small bowel location is extremely rare.
• Disseminated histoplasmosis typically affects lower GI Tract and rarely small bowel in addition to other organs.
• The association between Histoplasmosis and Cytomegalovirus as massive gastrointestinal bleeding cause has not been described.
• If disseminated histoplasmosis affects small bowel, causes intermittent abdominal pain, chronic diarrhoea and malabsorption.

IntroductionThe Cytomegalovirus (CMV) is a virus that affects the host and remains latent. When cellular immunity is suppressed, the virus is reactivated and can cause an asymptomatic or devastating infection in immunosuppressed patients.On the other hand, Histoplasmosis is typically a respiratory condition. However, in immunosuppressed patients, it may be found in unusual locations, as in the case of an intestinal condition. In some cases, this can be fatal.Small intestine CMV location is extremely rare.Case presentation40-year-old man with AIDS presenting secondary massive lower gastrointestinal bleeding (MLGB) symptoms and ulcer granulomatous injuries located in the proximal ileum produced by the association of CMV and histoplasmosis.ConclusionLower gastrointestinal bleeding diagnosis and treatment pose a challenge, considering the intestine extension and difficulties for its exploration. On the other hand, the association between Histoplasmosis and CMV as a massive gastrointestinal bleeding cause has not been described. There is no bibliography on the matter.