Potential association between calcified thoracic lymphadenopathy due to previous Histoplasma capsulatum infection and pulmonary Mycobacterium avium complex disease.

Background: Among patients with pulmonary disease due to Mycobacterium avium complex (MAC) seen recently at our center, a substantial number have had extensive calcified mediastinal, hilar, and peribronchial lymphadenopathy, a finding historically inconsistent with pulmonary MAC disease.

Method: We retrospectively studied the frequency of calcified lymphadenopathy in the chest and prevalence of known risk factors for MAC infection in 79 patients with pulmonary MAC disease who were referred to our hospital over a 1-year period.

Results: Calcified intrathoracic adenopathy was present in 25 of the 79 patients (32%).

Use of corticosteroids for treating dogs with airway obstruction secondary to hilar lymphadenopathy caused by chronic histoplasmosis: 16 cases (1979-1997).

Objective: To examine use of corticosteroids in treating dogs with airway obstruction secondary to hilar lymphadenopathy caused by chronic histoplasmosis.

Design: Retrospective study.

Animals: 16 dogs.

[American pulmonary histoplasmosis caused by Histoplasma capsulatum].

American pulmonary histoplasmosis is a deep mycosis imported from North America caused by the inhalation of Histoplasma capsulatum. It is endemic in several countries throughout the world and occasional cases have been reported in France, mainly imported from out lying French territories. The most frequent clinical forms observed in immunocompetent subjects are generally benign or silent and usually limited to a fortuitously discovered pulmonary nodule.

Pulmonary histoplasmosis in a Japanese male: report of a case.

A case of pulmonary histoplasmosis, which is rare in Japan, is reported herein. A 43-year-old man who had worked in Mexico for 2 years and had come back to Japan 3 months earlier, presented at our hospital because of an abnormal shadow on his chest roentogenogram with no symptoms. His chest roentogenogram as well as chest computed tomograms revealed a 2-cm-diameter nodule in the anterior basal segment of his right lung and an enlargement of the subcarinal lymph node.

[Disseminated histoplasmosis in AIDS patients. A study of 2 cases and review of the Spanish literature].

The characteristics of two cases of histoplasmosis in AIDS patients in our institution are presented together with a review of the 11 cases published in Spain since 1988 in addition to the current knowledge on histoplasmosis in patients with human immunodeficiency virus infection (HIV). In all except 2 of the 13 patients there was epidemiologic history of a stay in a country in which histoplasmosis is endemic. The 12 cases described in which this information is available had CD4 counts under 100/microL.

Approach to the diagnosis of pulmonary disease in patients infected with the human immunodeficiency virus.

Patients infected with the human immunodeficiency virus are predisposed to develop a variety of common and uncommon infectious and neoplastic pulmonary diseases. Clinical information that can stratify the risk of occurrence of these pulmonary conditions includes: 1) CD4 cell count-the most important determinant; 2) concurrent antimicrobial therapy; 3) prior travel history; 4) known latent infections that may reactivate: and 5) underlying respiratory disease. Specific pulmonary diseases are discussed including: bacterial pneumonia, bronchitis, mycobacterial and fungal infections, pneumocystis carinii pneumonia, toxoplasmosis, cytomegalovirus, Kaposi sarcoma, lymphoma, and lung cancer.

Unusual and infrequent indications for thoracoscopy.

A number of unusual or uncommon thoracoscopic indications have developed over the years. Pleural tuberculosis and blastomycosis, HIV infections, histoplasmosis, presenting as a nodular process have been diagnosed and treated. Fistulae or tube tract endoscopy may delineate whether a patient has persistence or recurrent carcinoma or tuberculosis through biopsy and culture techniques especially in the post pneumonectomy patient with an air leak.

Multicenter VATS experience with mediastinal tumors.

Background: The use of video-assisted thoracic surgery for diagnosis and treatment of mediastinal tumors in a multiinstitution patient population is not well understood.

Methods: We studied 48 cases from Cancer and Leukemia Group B thoracic surgeons. Of 21 men and 27 women, aged 41 +/- 16 years, 22 patients were asymptomatic.

Acute pulmonary histoplasmosis: progressive pneumonia resulting from high inoculum exposure.

Histoplasmosis is endemic in certain areas of North, Central, and South America, especially within the Ohio and Mississippi River Valleys of the United States. We describe a case of histoplasmosis in a farm-dwelling resident of Kentucky who probably had multiple prior opportunities for exposure. However, during the gathering of topsoil containing chicken droppings for use as fertilizer, he was likely to have been exposed to such a high inoculum of the organism that he developed a severe pulmonary infection.

[A tropical pulmonary nodule].

The authors report a case of american pulmonary histoplasmosis discovered by chance on a chest radiograph in a non immunocompromised patient, back from a stay in French Guyana. Confronted with the negativity of usual mycotic research, diagnosis has been made thanks to wedge excision by video-assisted thoracic surgery. The authors briefly sum up the recent facts regarding this imported infection, stressing the interest of a direct approach by surgical practices not very invasive that allow to eliminate with certainty neoplasm or tuberculosis.

Bronchoplasty in the management of low-grade airway neoplasms and benign bronchial stenoses.

Background: Parenchyma-sparing bronchoplastic procedures have altered the management of benign bronchial stenoses and low-grade neoplasms of the airway. Reliable techniques are available to allow sleeve resection of any lobe or the main bronchus and thus maximize preservation of lung parenchyma.

Methods: Between 1972 and 1995 we performed 100 bronchoplastic procedures on 99 patients.

Topical treatment of life threatening haemoptysis from aspergillomas.

Background: The efficacy of topical treatment of 12 episodes of severe life threatening haemoptysis from a pulmonary aspergilloma in 11 patients is reviewed.

Methods: A retrospective review was performed on five white and six African-American patients of mean age 49 years. The underlying diseases were bronchiectasis, sarcoidosis, tuberculosis, or histoplasmosis.

[Clinico-radiological correlations in pulmonary pathology caused by immunosuppression].

Lung is the most involved site by infective manifestations in immunodepressed patients. In these patients the variability of pathogenic and opportunistic agents is expressed in the lungs with interstitial and alveolar changes, which are not pathognomonic. CT is the appropriate method to study lung parenchyma.

Mucocutaneous histoplasmosis in AIDS.

A 36-year-old man, who was an intravenous drug abuser, developed thoracic herpes zoster, paronychia, oral candidosis, necrotizing gingivitis and bilateral parotid salivary gland swelling. Granulomatous oral lesions and ulceration on the nose were shown to be due to disseminated histoplasmosis.

Surgical and long-term antifungal therapy for fungal prosthetic valve endocarditis.

Background: Fungal prosthetic valve endocarditis is an uncommon but serious disease. We have developed a strategy of treatment that includes perioperative amphotericin B, radical debridement of infected tissue, reconstruction using biologic tissue when possible, and prolonged oral suppressive antifungal therapy.

Methods: We retrospectively reviewed the charts of 12 patients reoperated on for fungal prosthetic valve endocarditis involving the aortic valve (10 patients: six porcine valves, two mechanical valves, two homografts) and the mitral valve (2 patients, both porcine valves).

[African histoplasmosis due to Histoplasma capsulatum var. duboisii: relationship with AIDS in recent Congolese cases].

Six new cases are described for African histoplasmosis, Histoplasma capsulatum var. duboisii, from Congo. The first was an HIV sero-negative child who has been monitored for the last three years.

[Epidemic of pulmonary histoplasmosis after visiting a cave in New Caledonia].

We report an epidemic of acute pulmonary histoplasmosis which occurred in February 1994 among a group of 24 persons after they had once or twice visited a cave in New Caledonia. This study describes the physical and laboratory findings, which lead to the diagnosis of histoplasmosis. Each test was evaluated.

Thoracic mycoses from endemic fungi: radiologic-pathologic correlation.

The endemic fungi Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides immitis are primary human pathogens whose major portal of entry is the respiratory tract. Their clinical manifestations are categorized as acute, chronic or chronic progressive, or disseminated fungal disease. Most acute pulmonary infections are self-limited, and many are asymptomatic.

Bronchoscopic findings in a case of bronchopulmonary histoplasmosis.

At bronchoscopic examination extensive areas of fibrinous slough covering bronchial mucosal inflammation and ulceration were seen in a case of progressive diffuse bronchopulmonary histoplasmosis. Rigid bronchoscopy was needed to obtain sufficient biopsy material for specific histological diagnosis.

Mediastinal histoplasmosis presenting with esophageal involvement and dysphagia: case study.

Esophageal involvement with histoplasmosis is uncommon, but has been recognized in two clinical settings. Most commonly, the esophagus becomes involved as a result of contiguous mediastinal lymphadenopathy. Such patients usually present with dysphagia secondary to midesophageal compression or stricture.

[Round pulmonary lesions after returning from French Guyana. Six cases of american pulmonary histoplasmosis].

From 1989 to 1994, 71 patients were hospitalized for diagnosis of round lung lesions including 49 servicemen under the age of 45 years who had been stationed in tropical areas. In 6 of these servicemen, the diagnosis was pulmonary histoplasmosis at the tertiary stage of histoplasmoma. All had done duty in French Guyana and were negative for human immunodeficiency virus.

Extrapulmonary thoracic disease caused by Blastomyces dermatitidis.

A case of blastomycosis is reported involving the mediastinum and compromising the plexus brachialis. The pathology, pathophysiology, and treatment of this patient and of a previously reported patient are discussed and compared with the characteristics of extrapulmonary thoracic disease caused by histoplasmosis. Because of the favorable response of these patients to prolonged antifungal therapy, blastomycosis should be considered in the differential diagnosis of invasive extrapulmonary thoracic disease.