Fibrosing mediastinitis: a rare complication of histoplasmosis.

Abstract

We report a case of a 29-year-old man who presented with intermittent haemoptysis for about 18 months. Previously, his symptoms had been diagnosed as musculoskeletal pain and later as pneumonia. CT found a venous infarct in the right lung in addition to extensive lymphadenopathy in the mediastinum and pulmonary hila, with associated calcifications almost completely occluding the superior vena cava and azygos vein. Further questioning revealed that the patient had once worked on an organic farm in Colorado. Subsequent work up was positive for histoplasmosis yeast antibodies. The patient was diagnosed with fibrosing mediastinitis (FM) and started on itraconazole for 3 months. We note that FM is a rare complication of histoplasmosis and can present as chronic haemoptysis. Travel history is an important aspect of the clinical evaluation. Antifungal agents have shown some efficacy in treating histoplasmosis-related FM.

• Authors: Milesh Patel, Frederic Lu, Maria Hannaway, Katherine Hochman
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2015 (Nov 04 2015) ISSN: 1757-790X [Electronic] England
• PMID: 26538131 (Publication Type: Case Reports, Journal Article)
• Copyright: 2015 BMJ Publishing Group Ltd.

Chemical References

• Antifungal Agents
• Itraconazole

Topics

• Adult
• Antifungal Agents (therapeutic use)
• Fibrosis
• Hemoptysis (microbiology)
• Histoplasmosis (complications, drug therapy)
• Humans
• Itraconazole (therapeutic use)
• Male
• Mediastinitis (microbiology)
• Mediastinum (pathology)