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Ann Thorac Surg 1986;42:711-722
© 1986 The Society of Thoracic Surgeons

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Articles

Surgical Intervention in Histoplasmosis

From the Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO

^* Address reprint requests to Dr. Roper, 3108 Queeny Tower, Barnes Hospital Plaza, St. Louis, MO 63110

Histoplasmosis is a ubiquitous disease in endemic areas that has a generally subclinical course. Excessive inflammatory response may bring some patients to the attention of a thoracic surgeon to exclude malignancy of a noncalcified pulmonary or mediastinal mass or to relieve compression of specific structures. Mediastinal granuloma or fibrosing mediastinitis may involve the superior vena cava, pulmonary vessels, heart and pericardium, tracheobronchial tree, or esophagus. The cases of 94 recently treated patients are presented as well as a review of the American surgical literature. The current use of computed tomography, the time and extent of operative intervention, and the role of antifungal therapy are important to an overall understanding of the surgical treatment of the manifestations of histoplasmosis.

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