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Histoplasmosis during childhood

J C Butler1, R Heller, P F Wright

  • 1Department of Pediatrics, Vanderbilt University, Nashville, Tenn.

Southern Medical Journal
|April 1, 1994
PubMed
Summary
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Histoplasmosis in children often presents with prolonged fever and cough, sometimes with wheezing. Consider this fungal infection in endemic areas, especially with chest X-ray findings like adenopathy.

Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Pulmonology

Background:

  • Histoplasmosis is a fungal infection endemic to certain regions.
  • Clinical presentation in children can vary, necessitating clear diagnostic criteria.
  • Understanding pediatric histoplasmosis is crucial for timely diagnosis and treatment.

Purpose of the Study:

  • To define the clinical presentation of histoplasmosis in hospitalized children.
  • To identify common symptoms, physical findings, and radiographic features.
  • To aid in the differential diagnosis of pediatric respiratory illnesses.

Main Methods:

  • Retrospective chart review of 35 pediatric patients diagnosed with histoplasmosis.
  • Analysis of clinical symptoms, physical examinations, chest radiographs, and diagnostic test results.

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  • Inclusion criteria: diagnosis by culture, pathology, or serology between 1968-1988.

    • Main Results:

    • Pulmonary/mediastinal infection was most common (83%), followed by disseminated (14%) and cutaneous (3%).
    • Fever (>2 weeks) and cough were prevalent symptoms; wheezing was a common physical finding.
    • Chest radiographs frequently showed adenopathy (74%) and infiltrates (56%).

    Conclusions:

    • Histoplasmosis should be considered in children from endemic areas presenting with persistent fever, cough, or wheezing.
    • Radiographic adenopathy in children with these symptoms warrants further investigation for histoplasmosis.
    • The study highlights the importance of considering fungal infections in pediatric differential diagnoses.