Reeves Collin, Tobias Michael P, Bline Katherine, Tobias Joseph D
Heritage College of Osteopathic Medicine - Dublin Campus, Dublin, Ohio and Ohio University, Athens, OH, USA.
Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
J Med Cases. 2024 Sep;15(9):237-241. doi: 10.14740/jmc4279. Epub 2024 Aug 22.
Primary infection related to the fungus, histoplasmosis, is generally asymptomatic in immunocompetent hosts. Calcified granulomas may be noted incidentally on radiologic imaging such as chest radiographs or computed tomography imaging. However, even in immunocompetent hosts, these primary infections occasionally result in end-organ involvement including respiratory compromise. Histoplasmosis should be included in the differential diagnosis of patients presenting with respiratory involvement and mediastinal adenopathy. We present two pediatric-aged patients who developed pulmonary involvement related to a primary histoplasmosis infection that resulted in mediastinal and tracheal lymphadenopathy. These led to respiratory compromise due to pleural effusion in the first patient and tracheal compression in the second. In this paper, the basic microbiology of is presented, previous reports of primary respiratory involvement presented, and diagnostic and therapeutic options discussed.
与真菌荚膜组织胞浆菌相关的原发性感染在免疫功能正常的宿主中通常无症状。钙化性肉芽肿可能在胸部X光片或计算机断层扫描成像等放射影像学检查中偶然发现。然而，即使在免疫功能正常的宿主中，这些原发性感染偶尔也会导致包括呼吸功能受损在内的终末器官受累。组织胞浆菌病应纳入有呼吸受累和纵隔淋巴结肿大患者的鉴别诊断中。我们报告了两名儿童患者，他们因原发性组织胞浆菌感染而出现肺部受累，导致纵隔和气管淋巴结肿大。这分别导致了第一名患者因胸腔积液、第二名患者因气管受压而出现呼吸功能受损。本文介绍了荚膜组织胞浆菌的基本微生物学，呈现了以往原发性呼吸受累的报告，并讨论了诊断和治疗选择。
