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Unexplained right hilar mass.

G L Darrow1, G Medis

  • 1Janesville Medical Center, Wisconsin.

Postgraduate Medicine
|February 1, 1989
PubMed
Summary

A rare case of progressive histoplasmosis presented as a right hilar mass in a 40-year-old man. Surgical biopsy confirmed the fungal infection, highlighting the need for accurate diagnosis and treatment options.

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Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Medical Mycology

Background:

  • Histoplasmosis is a fungal infection, often asymptomatic or self-limited.
  • Computed tomographic (CT) scans are crucial for initial diagnosis of pulmonary abnormalities.

Observation:

  • A 40-year-old man presented with fever, sore throat, and malaise.
  • A right hilar mass was detected on CT scan, which increased in size on repeat scans.
  • Initial tests for bacterial, viral infections, and carcinoma were negative.

Findings:

  • Surgical biopsy of the right lower lobe confirmed disseminated histoplasmosis.
  • This case illustrates a severe presentation of a typically mild fungal infection.

Implications:

  • Accurate diagnosis of histoplasmosis is essential, even in atypical presentations.
  • Ketoconazole offers a less toxic treatment alternative to amphotericin B for severe histoplasmosis.

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