Gastric Outlet Obstruction Caused by Histoplasmosis in a Nonendemic Region

<i>Histoplasmosis capsulatum</i> is a dimorphic fungus commonly considered endemic in the Mississippi and Ohio River Valley regions. Histoplasmosis can present as asymptomatic in immunocompetent patients or present as a disseminated infection in immunocompromised patients. Diagnosing histoplasmosis can be challenging in nonendemic areas, especially in patients presenting primarily with gastrointestinal symptoms. We describe a case of an immunocompromised 29-year-old man presenting with gastric outlet obstruction caused by disseminated histoplasmosis in a region not commonly considered endemic to <i>Histoplasmosis capsulatum</i>.