Asymptomatic colonic histoplasmosis in a patient receiving methotrexate.

Disease due to infection with Histoplasma capsulatum usually manifests as a disseminated infection in patients with the Acquired Immunodeficiency Syndrome (AIDS). However, it may also present with focal disease in patients with or without AIDS. Unusual presentations or less well-recognized risk factors may make diagnosis of histoplasmosis more difficult. We describe the case of a patient who presented for screening colonoscopy and was found to have isolated asymptomatic colonic histoplasmosis.