Surgical Management of Pulmonary and Mediastinal Sequelae of Histoplasmosis: A Challenging Spectrum

Zane T. Hammoud, Anthony S. Rose, Chadi Hage, Kenneth S. Knox, Karen Rieger, Kenneth Kesler

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Histoplasmosis may result in a spectrum of complications that require thoracic surgical intervention. We reviewed our 17-year experience in the management of histoplasmosis to determine outcomes as well as gain insight into the distribution of complications requiring surgical intervention. Methods: The hospital records of patients who underwent surgical treatment for complications related to histoplasmosis from 1991 to 2008 were reviewed. Based on the predominant presentation, patients were categorized with complications secondary to broncholithiasis, granulomatous disease, or fibrosing mediastinitis. Patients who underwent diagnostic surgery and were found to have histoplasmosis were excluded. Results: Of the 49 patients who underwent surgery for histoplasmosis-related complications, 27 (55%) had granulomatous disease, 13 (27%) had broncholithiasis, and 9 (18%) had fibrosing mediastinitis. The most common clinical presentations were recurrent pneumonia (n = 16) and hemoptysis (n = 13); less common presentations included dysphagia (n = 3) and superior vena cava syndrome (n = 1). Two patients required cardiopulmonary bypass for resection; 1 of these died postoperatively (series mortality 2%). Seven patients (14%) had complications. Relief of symptoms was achieved in all surviving patients. Conclusions: Complications of histoplasmosis requiring thoracic surgical intervention are diverse with pulmonary complications predominating. Although surgically challenging, excellent short- and long-term outcomes may be expected.

Original languageEnglish
Pages (from-to)399-403
Number of pages5
JournalAnnals of Thoracic Surgery
Volume88
Issue number2
DOIs
StatePublished - Aug 2009

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Histoplasmosis
Lung
Thorax
Superior Vena Cava Syndrome
Hemoptysis
Hospital Records
Deglutition Disorders
Cardiopulmonary Bypass
Pneumonia
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Surgical Management of Pulmonary and Mediastinal Sequelae of Histoplasmosis : A Challenging Spectrum. / Hammoud, Zane T.; Rose, Anthony S.; Hage, Chadi; Knox, Kenneth S.; Rieger, Karen; Kesler, Kenneth.

In: Annals of Thoracic Surgery, Vol. 88, No. 2, 08.2009, p. 399-403.

Research output: Contribution to journalArticle

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