Surgical intervention in histoplasmosis |
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| Authors: | H E Garrett C L Roper |
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| Affiliation: | 1. Division of Pediatric Otolaryngology—Head and Neck Surgery, Faculty of Medicine, University of British Columbia and B.C. Children''s Hospital, 4480 Oak Street, Vancouver, BC, Canada V6H 3V4;2. Undergraduate Medical Program, Faculty of Medicine, University of British Columbia and B.C. Children''s Hospital, 4480 Oak Street, Vancouver, BC, Canada V6H 3V4;3. Division of Pediatric Cardiac Surgery, Faculty of Medicine, University of British Columbia and B.C. Children''s Hospital, 4480 Oak Street, Vancouver, BC, Canada V6H 3V4;1. Clinic of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;2. Clinic for Vascular Surgery, Kantonsspital St Gallen, St Gallen, Switzerland;1. Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA;2. Department of Cardiology, Texas Heart Institute, Houston, Texas, USA;3. Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA;4. Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA;5. Departments of Neurology and Epidemiology, University of Washington, Seattle, Washington, USA |
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| Abstract: | 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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