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Histoplasmosis: clinical manifestations and surgical management
Abstract:
In this retrospective study of 115 cases of histoplasmids, there were 66 male and 49 female patients ranging in age from 2 months to 79 years. The most common presenting symptoms were cough, chest pain, wheezing, weight loss, hemoptysis, and shortness of breath. Thirty-five patients (30%) were asymptomatic. Two patients had manifestations of obstruction of the superior vena cava. Radiologic findings simulated carcinoma, tuberculosis, pneumonia, and viral infections. Sixty-five patients had various operative proceudres, such as lung biopsy, wedge resection, lobectomy, pneumonectomy, resection of lymph node, and bypass of superior vena cava, for diagnosis and treatment. There were two deaths and two postoperative complications. A total of 15 patients received intravenous amphotericin B. Four patients with pneumonic infiltrates developed disseminated histoplasmosis.
Insights
Histoplasmosis, a fungal infection, presents with varied symptoms like cough and chest pain, often mimicking other lung diseases. Early diagnosis and treatment are crucial for managing this condition.
Area of Science:
- Pulmonology
- Infectious Diseases
- Medical Mycology
Background:
- Histoplasmosis is a fungal infection caused by Histoplasma capsulatum.
- It can present with a wide range of clinical manifestations, from asymptomatic infection to severe disseminated disease.
- Radiographic findings can be nonspecific, often simulating other pulmonary conditions.
Purpose of the Study:
- To review the clinical presentation, diagnostic methods, and treatment outcomes of histoplasmosis.
- To highlight the varied radiologic findings and their differential diagnoses.
- To assess the complications and mortality associated with histoplasmosis.
Main Methods:
- Retrospective analysis of 115 cases of histoplasmosis.
- Review of patient demographics, presenting symptoms, radiologic findings, and operative procedures.
- Analysis of treatment regimens, including amphotericin B, and patient outcomes.
Main Results:
- The study included 115 patients (66 male, 49 female) aged 2 months to 79 years.
- Common symptoms included cough, chest pain, wheezing, weight loss, hemoptysis, and shortness of breath; 30% were asymptomatic.
- Radiologic findings mimicked carcinoma, tuberculosis, pneumonia, and viral infections. Surgical interventions were performed on 65 patients. Two deaths and two complications occurred. Fifteen patients received amphotericin B; four with pneumonic infiltrates developed disseminated disease.
Conclusions:
- Histoplasmosis presents with diverse symptoms and radiologic findings, often requiring invasive procedures for diagnosis.
- The condition can mimic other serious pulmonary diseases, necessitating a high index of suspicion.
- Prompt diagnosis and appropriate management, including antifungal therapy, are essential for favorable outcomes.