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Related Experiment Videos

The endemic mycoses: surgical considerations

P C Johnson1, G A Sarosi

  • 1Department of Internal Medicine, The University of Texas Medical School, Houston, USA.

Seminars in Thoracic and Cardiovascular Surgery
|April 1, 1995
PubMed
Summary

Surgical consultation is vital for diagnosing and treating fungal lung infections like histoplasmosis and coccidioidomycosis, which mimic cancer. New oral therapies and HIV complications are key considerations.

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Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Endemic mycoses (Histoplasma capsulatum, Blastomyces dermatitidis, Coccidioidomycosis immitis) and Cryptococcus neoformans frequently cause pulmonary complications.
  • These fungal infections often present with symptoms mimicking pulmonary malignancies, necessitating specialized diagnostic and treatment approaches.
  • Complications include pericarditis, mediastinal fibrosis, granulomas, spontaneous pneumothorax, and superinfected cavities, particularly in individuals with human immunodeficiency virus (HIV).

Purpose of the Study:

  • To review the pathogenesis, diagnosis, and treatment of pulmonary fungal infections.
  • To highlight surgical consultation's role in managing these complex cases.
  • To discuss emerging oral therapies and challenges in immunocompromised patients, specifically those with HIV.

Main Methods:

  • Literature review focusing on endemic mycoses and Cryptococcus neoformans.
  • Analysis of clinical presentations, diagnostic modalities, and therapeutic strategies.
  • Emphasis on surgical management and complications, including those in HIV-infected individuals.

Main Results:

  • Fungal infections present diagnostic challenges due to resemblance to lung cancer.
  • Specific mycoses lead to distinct complications: Histoplasmosis (pericarditis, mediastinal issues), Coccidioidomycosis (pneumothorax, cavities).
  • New oral therapies offer treatment options, but HIV complicates management.

Conclusions:

  • Surgical consultation is crucial for the accurate diagnosis and management of pulmonary fungal infections.
  • Understanding the specific complications of each mycosis and the impact of HIV is essential for effective treatment.
  • Advances in oral therapies are improving patient outcomes, but careful monitoring is required.

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