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荚膜组织胞浆菌感染兼具肉芽肿特征和纤维性纵隔炎，表现为呼吸急促：一例报告

Histoplasma capsulatum Infection With Both Granulomatous Features and Fibrosing Mediastinitis Presenting as Shortness of Breath: A Case Report.

作者信息

Kozloski Ryan M, Donohue Alec K, Sparks Preston J, Robertson Janelle L, Hostler David C

机构信息

Internal Medicine, Womack Army Medical Center, Fort Liberty, USA.

General Surgery, Womack Army Medical Center, Fort Liberty, USA.

出版信息

Cureus. 2024 Sep 28;16(9):e70398. doi: 10.7759/cureus.70398. eCollection 2024 Sep.

DOI:10.7759/cureus.70398
PMID:39473685
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11518698/
Abstract

It is known that Histoplasma capsulatum can cause chronic granulomatous disease or fibrosing mediastinitis, but both presentations occurring in the same patient is exceedingly rare and difficult to diagnose. The patient is a 24-year-old female with a past medical history of asthma, who presented for worsening shortness of breath. Thoracic imaging revealed a large paratracheal mass with a significant mass effect. Endobronchial ultrasound (EBUS) was attempted unsuccessfully, and the patient underwent video-assisted thoracoscopic surgery, which established the diagnosis of fibrosing mediastinitis. Extensive infectious disease workup confirmed Histoplasma infection. She was treated with a course of Itraconazole, pulmonary artery stenting, and rituximab.

摘要

已知荚膜组织胞浆菌可引起慢性肉芽肿病或纤维性纵隔炎，但这两种表现出现在同一患者身上极为罕见且难以诊断。该患者为一名24岁女性，有哮喘病史，因气短加重前来就诊。胸部影像学检查发现气管旁有一个大肿块，有明显的肿块效应。尝试进行支气管内超声（EBUS）检查未成功，患者接受了电视辅助胸腔镜手术，确诊为纤维性纵隔炎。广泛的传染病检查证实为组织胞浆菌感染。她接受了一个疗程的伊曲康唑治疗、肺动脉支架置入术和利妥昔单抗治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e90b/11518698/82fa33631305/cureus-0016-00000070398-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e90b/11518698/f8445083a053/cureus-0016-00000070398-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e90b/11518698/583bf42882f5/cureus-0016-00000070398-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e90b/11518698/4815d1bfa485/cureus-0016-00000070398-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e90b/11518698/82fa33631305/cureus-0016-00000070398-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e90b/11518698/f8445083a053/cureus-0016-00000070398-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e90b/11518698/583bf42882f5/cureus-0016-00000070398-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e90b/11518698/4815d1bfa485/cureus-0016-00000070398-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e90b/11518698/82fa33631305/cureus-0016-00000070398-i04.jpg

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本文引用的文献

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