Cardiac Implications of Itraconazole Therapy in Histoplasmosis Patients.

A male patient in his 60s, with a history of tobacco use, presented with fever, weight loss, and cough, and was ultimately diagnosed with histoplasmosis. Initial treatment with itraconazole (ITZ) led to symptom improvement. However, two months later, he returned with lower extremity swelling and dyspnea.

A case report of constrictive pericarditis following COVID-19 vaccination.

Background: COVID-19 infection and the COVID-19 vaccines have been associated with rare cases of pericarditis. We present a case of constrictive pericarditis (CP) following the vaccine.

Case Summary: A 19-year-old healthy male started having progressive abdominal pain, emesis, dyspnoea, and pleuritic chest pain 2 weeks after the second dose of Pfizer vaccine.

Unexpected fibrous mediastinitis in a patient with myasthenia gravis - a case report.

Background: Fibrous mediastinitis (FM) is a rare mediastinal lesion characterized by proliferation of fibrous tissue within the mediastinum. Previous reports have shown that this lesion can be caused by histoplasmosis and tuberculosis. In extremely rare cases, FM can also be caused by autoimmune diseases such as antineutrophil cytoplasmic antibody-associated vasculitis and large-vessel arteritis.

Pulmonary Histoplasmosis in People Living with Human Immunodeficiency Virus in French Guiana: Clinical Epidemiology, Medical Imaging and Prognostic.

Background: Histoplasmosis is mainly described as a disseminated disease in people living with HIV (PLHIV). Compared to historical descriptions in immunocompetent individuals, knowledge is lacking on the detailed clinical and radiological findings and outcomes of pulmonary histoplasmosis (PH). Overlooked or misdiagnosed with other AIDS-defining condition, prognostic of PLHIV may be at risk because of inappropriate care.

Intramedullary histoplasmosis of the thoracic cord as an isolated lesion: A rare case report and literature review.

Background: Disseminated histoplasmosis involving the central nervous system occurs in 5-10% of cases. However, intramedullary spinal cord lesions are extremely rare. Here, 45-year-old female with a T8-9 intramedullary lesion did well following surgical extirpation.

Chronic Tubercular Mediastinitis: A Rare Case Presentation With Subcutaneous Emphysema.

Tuberculosis, histoplasmosis, various fungal infections, malignancy, and sarcoidosis are the most common causes of chronic or slowly progressing mediastinitis. Chronic mediastinitis of tubercular origin with subcutaneous emphysema is exceptionally uncommon, and the majority of cases are caused by trauma. Here we report the case of a 35-year-old chronic alcoholic male who presented to the Outpatient Department (OPD) with complaints of cough, chest pain, loss of weight, and intermittent low-grade fever for three months with no significant past medical history or family history for any respiratory diseases.

Differential diagnosis of pulmonary sarcoidosis: a review.

Diagnosing pulmonary sarcoidosis raises challenges due to both the absence of a specific diagnostic criterion and the varied presentations capable of mimicking many other conditions. The aim of this review is to help non-sarcoidosis experts establish optimal differential-diagnosis strategies tailored to each situation. Alternative granulomatous diseases that must be ruled out include infections (notably tuberculosis, nontuberculous mycobacterial infections, and histoplasmosis), chronic beryllium disease, hypersensitivity pneumonitis, granulomatous talcosis, drug-induced granulomatosis (notably due to TNF-a antagonists, immune checkpoint inhibitors, targeted therapies, and interferons), immune deficiencies, genetic disorders (Blau syndrome), Crohn's disease, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, and malignancy-associated granulomatosis.

tympanomastoiditis: Case report and literature review.

is a dimorphic fungus capable of producing a diverse array of clinical pathology in humans dependent upon the host immune status. Acute symptomatic infection typically presents as an isolated pulmonary or nodal disease in immunocompetent patients with extra-thoracic manifestations rarely seen in this population. In this report, we describe a novel case of tympanomastoiditis in an immunocompetent patient who presented with progressively worsening purulent otorrhea, vertigo, and facial nerve palsy.

Improving lung cancer diagnosis with cancer, fungal, and imaging biomarkers.

Objective: Indeterminate pulmonary nodules (IPNs) represent a significant diagnostic burden in health care. We aimed to compare a combination clinical prediction model (Mayo Clinic model), fungal (histoplasmosis serology), imaging (computed tomography [CT] radiomics), and cancer (high-sensitivity cytokeratin fraction 21; hsCYFRA 21-1) biomarker approach to a validated prediction model in diagnosing lung cancer.

Methods: A prospective specimen collection, retrospective blinded evaluation study was performed in 3 independent cohorts with 6- to 30-mm IPNs (n = 281).

Improving Lung Cancer Diagnosis with CT Radiomics and Serum Histoplasmosis Testing.

Background: Indeterminate pulmonary nodules (IPN) are a diagnostic challenge in regions where pulmonary fungal disease and smoking prevalence are high. We aimed to determine the impact of a combined fungal and imaging biomarker approach compared with a validated prediction model (Mayo) to rule out benign disease and diagnose lung cancer.

Methods: Adults ages 40 to 90 years with 6-30 mm IPNs were included from four sites.

An Unusual Clinical Outcome and Surgical Intervention for Mediastinal Histoplasmosis.

, an endemic mycosis in the United States, can result in a variety of clinical manifestations. When encountering histoplasmosis sequelae, such as mediastinal adenitis, granulomas, and fibrosing mediastinitis, surgical management may be an unexpected but necessary treatment. Due to the complexity of the mediastinum, it is imperative to have optimal operative planning.

A Case Report of -Associated Empyema Treated With Intravenous Injection and Local Thoracic Irrigation of Amphotericin B Plus Medical Thoracoscopy.

Cases of empyema associated with infection are rarely reported. Here, we discuss a case of -associated empyema successfully treated with amphotericin B intravenous and pleural infusion therapy and multiple medical thoracoscopies. A 57-year-old Chinese woman with preexisting diabetes mellitus and gastric cancer had massive left-sided pleural effusion diagnosed by chest computed tomography.

Lung and Mediastinal Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Young Adults.

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is used to investigate pulmonary nodules, mediastinal lymphadenopathy, and mediastinal masses in both malignant and nonmalignant etiologies. EBUS-TBNA is most commonly used in the diagnosis and staging of patients with non-small-cell lung cancer in the middle-age and elderly populations. As lung cancer is uncommon in young adults, it is assumed that there are a distinct disease population and clinical background in young adults who undergo EBUS-TBNA.

A Structured Program Maximizes Benefit of Lung Cancer Screening in an Area of Endemic Histoplasmosis.

Background: Lung cancer screening with low-dose computed tomography has demonstrated at least a 20% decrease in lung cancer-specific mortality, but it has the potential harm of unnecessary invasive procedures performed because of false-positive results. This study reports the outcomes of a structured multidisciplinary lung cancer screening program in an area of endemic histoplasmosis.

Methods: A retrospective review of patients undergoing lung cancer screening from December 2012 to March 2019 was conducted.

Case series of pediatric mediastinal granuloma related to histoplasmosis.

Introduction: Mediastinal granuloma (MG) is a postinfectious complication of histoplasmosis that remains a rare diagnosis in the pediatric literature. This case series presents a well phenotyped population to further characterize this disease process.

Methods: Thirty cases of MG in children under 21 years-of-age presenting over a 16-year period were retrospectively analyzed.

Pulmonary histoplasmosis diagnosed in a Japanese woman after traveling to central and South America: A case report.

Histoplasmosis is a fungal infection caused by Histoplasma capsulatum, and Japan is considered a non-endemic area for histoplasmosis. Most patients diagnosed with histoplasmosis in the past usually have exposure to caves and bat guano with travel history to endemic areas. Therefore, travel history and risk activities should be comprehensively assessed when suspecting histoplasmosis because this important information may be overlooked.

Mucocutaneous nasal histoplasmosis in an immunocompetent dog.

Background: Histoplasma (H.) capsulatum is a dimorphic fungus, and infection is typically via inhalation of microconidia. After conversion to the yeast phase within the lung, the organism is subsequently disseminated to other tissues by macrophages.

Spontaneous pneumothorax secondary to chronic cavitary pulmonary histoplasmosis.

Histoplasma capsulatum is a dimorphic fungus that causes histoplasmosis. Chronic cavitary pulmonary histoplasmosis is rare, and typically manifests as apical cavitary lesions in patients with pre-existing chronic obstructive pulmonary disease. We report a case involving a 60-year-old female who presented to our facility with acute onset of dyspnea and dry cough.

Clinical implications of pulmonary nodules detected in children.

Introduction: The management of children found to have pulmonary nodules is not well established. We determined how often diagnostic testing was pursued, the outcome of diagnostic testing, and how often pulmonary nodules were given a definitive diagnosis.

Method: A retrospective review of patients found to have pulmonary nodules.