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Esophageal diverticulum: a complication of histoplasmosis in children

Steven J Steiner1, Elaine G Cox, Sandeep K Gupta

  • 1Division of Pediatric Gastroenterology/Hepatology/Nutrition, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis 46202-5225, USA.

The Journal of Pediatrics
|March 10, 2005
PubMed

Insights

Three boys with dysphagia or chest pain were diagnosed with mid-esophageal traction diverticula and histoplasmosis. This condition appears linked to esophageal traction from infected lymph nodes, with full recovery after treatment.

Area of Science:

  • Gastroenterology
  • Pediatric Medicine
  • Infectious Diseases

Background:

  • Esophageal symptoms like dysphagia and chest pain can indicate serious underlying conditions.
  • Histoplasmosis is a fungal infection that can affect various organs, including lymph nodes.

Observation:

  • Three male patients aged 8-14 presented with eating-related dysphagia or chest pain.
  • Diagnostic imaging (esophagrams, EGD) revealed mid-esophageal traction diverticula in all patients.
  • Serological tests indicated acute or recent histoplasmosis.

Findings:

  • Mid-esophageal traction diverticula were associated with histoplasmosis in these pediatric patients.
  • The diverticula are hypothesized to form due to esophageal traction from inflamed, infected adjacent lymph nodes.
  • Individualized antifungal and anti-inflammatory treatments led to complete recovery for all patients.

Implications:

  • This case series highlights a potential link between histoplasmosis and the development of esophageal traction diverticula in children.
  • Early diagnosis and appropriate treatment of histoplasmosis may prevent or resolve esophageal complications.
  • Understanding this association can improve diagnostic and therapeutic strategies for pediatric esophageal conditions.

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