PMC5247624_01
(A and B) Balloon endoscopy showing intrinsic ileal stricture with ulcerative changes.
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F1
On upper balloon enteroscopy, a benign-appearing intrinsic severe stenosis measuring 10 mm in length by 3 mm inner diameter with associated ulcerations was found in the distal ileum (Figure 1).
Grocott-Gomori's methenamine silver stain from small bowel biopsy demonstrating Histoplasma capsulatum.
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F2
Microscopic examination of the stricture biopsies showed acute ulcerative and granulomatous ileitis with inflammatory granulation tissue positive for plentiful fungal organisms morphologically typical of Histoplasma species (Figure 2).