Histoplasma capsulatum Infection With Both Granulomatous Features and Fibrosing Mediastinitis Presenting as Shortness of Breath: A Case Report.

It is known that Histoplasma capsulatum can cause chronic granulomatous disease or fibrosing mediastinitis, but both presentations occurring in the same patient is exceedingly rare and difficult to diagnose. The patient is a 24-year-old female with a past medical history of asthma, who presented for worsening shortness of breath. Thoracic imaging revealed a large paratracheal mass with a significant mass effect.