Published : 21 Sep 2026, 06:19 PM
Updated : 21 Sep 2026, 06:19 PM
A rare and aggressive fungal infection has killed a 26-year-old Bangladeshi man after doctors repeatedly mistook it for tuberculosis.
The case highlights how the uncommon infection can mimic far more prevalent diseases, making diagnosis difficult, according to a new case study.
The man suffered months of abdominal pain and lost 16kg before doctors identified the true cause of his deteriorating condition, reports The Independent.
Physicians initially suspected intestinal tuberculosis or Crohn's disease, given Bangladesh's high TB burden and the patient's family history of the disease.
Even after two colonoscopies and a 60-day course of TB treatment that produced no improvement, the correct diagnosis remained elusive.
The culprit was eventually identified as Histoplasma capsulatum, a fungus that typically causes severe illness only in people with compromised immune systems, such as those living with HIV or undergoing immunosuppressive therapy.
What makes the Bangladesh case particularly unusual is that the patient had no known immune deficiency.
By the time anti-fungal treatment could be initiated, the disease had progressed too far.
The man died within hours of diagnosis from a gastrointestinal haemorrhage, doctors reported in the journal Clinical Case Reports.
Histoplasma capsulatum grows as a mould in soil enriched with bat droppings and is inhaled as spores from contaminated environments such as caves, poultry farms and construction sites.
It is most commonly associated with the Ohio and Mississippi River valleys in the United States, though cases have been reported across parts of Central and South America, Africa and South Asia, including the Indian subcontinent, according to The Independent.
In the vast majority of those exposed, the infection stays confined to the lungs and either produces no symptoms or mild respiratory illness.
In rare instances, however, the fungus spreads beyond the lungs in a condition called disseminated histoplasmosis, which can be fatal.
The authors of the case study warn that such infections risk being overlooked in TB-endemic regions, where overlapping symptoms can send clinicians down the wrong diagnostic path.
They urge doctors to consider disseminated histoplasmosis even in patients without apparent immune deficiencies when ileocecal disease is present and TB treatment fails to bring improvement.
"Delayed diagnosis carries a high risk of catastrophic gastrointestinal haemorrhage, which may be irreversible even after anti-fungal therapy is initiated," the researchers warned.
