A Case Series and Review of Histoplasmosis Infection in the Neck

Johnson, Jennifer A.; Loyd, James E.; Wheat, L. Joseph; Netterville, James L.

doi:10.1001/archoto.2010.143

Cited by 8 publications

(7 citation statements)

References 10 publications

(6 reference statements)

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“…Symptoms usually develop from attachment, fistulization, and subsequent drainage of semiliquid contents, typically described as pus, into adjacent structures, including bronchi, lung parenchyma, esophagus, or surgical tracts if mediastinoscopy was performed. 61 Some MGs fistulize and drain, and empty most or all of their contents, and then remain quiescent indefinitely. In contrast, other MG may reactivate at your regular intervals, often months, usually heralded by low-grade fever, malaise, and night sweats.…”

Section: Clinical Findingsmentioning

confidence: 99%

Histoplasmosis: Up-to-Date Evidence-Based Approach to Diagnosis and Management

Hage

Azar

Bahr

et al. 2015

Semin Respir Crit Care Med

122

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Histoplasmosis is the most common endemic mycosis in the North America, Central America, and many countries of South America and also occurs in China, India, Southeast Asia, Africa, Australia, and Europe. Clinical syndromes are not specific and histoplasmosis often is overlooked in the evaluation of patients with community-acquired pneumonia, chronic cavitary pneumonia resembling tuberculosis or anaerobic infection, granulomatous inflammatory diseases such as sarcoidosis or Crohn disease, and malignancy. The diagnosis depends on understanding the geographic distribution, common clinical presentations, and tests used for diagnosis of histoplasmosis. While histoplasmosis resolves without treatment in most patients, treatment is indicated in all immunocompromised patients and those with progressive disseminated disease or chronic pulmonary disease. Treatment is appropriate in most patients with acute pulmonary disease but rarely in those with other pulmonary or mediastinal manifestations. The preferred agents include liposomal amphotericin B for more severe cases and itraconazole for milder cases and "step-down" therapy following response to amphotericin B.

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Section: Clinical Findingsmentioning

confidence: 99%

Histoplasmosis: Up-to-Date Evidence-Based Approach to Diagnosis and Management

Hage

Azar

Bahr

et al. 2015

Semin Respir Crit Care Med

122

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“…Complications include attachment to nearby structures, fistulization, with subsequent drainage of semiliquid, purulent-appearing contents into adjacent structures, including bronchi, lung parenchyma, esophagus, or surgical tracts if mediastinoscopy was performed. 86 In some cases, MG may fistulize and empty most or all of their contents and then remain dormant. Alternatively, a quiescent MG may also become symptomatic at regular intervals, often a few months, heralded by low-grade fever, malaise, and night sweats.…”

Section: Mediastinal Granulomamentioning

confidence: 99%

Current Concepts in the Epidemiology, Diagnosis, and Management of Histoplasmosis Syndromes

Azar

Loyd

Relich

et al. 2020

Semin Respir Crit Care Med

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Histoplasmosis is a global disease endemic to regions of all six inhabited continents. The areas of highest endemicity lie within the Mississippi and Ohio River Valleys of North America and parts of Central and South America. As a result of climate change and anthropogenic land utilization, the conditions suitable for Histoplasma capsulatum are changing, leading to a corresponding change in epidemiology. The clinical manifestations of histoplasmosis are protean, variably resembling other common conditions such as community-acquired pneumonia, tuberculosis, sarcoidosis, Crohn's disease, or malignancy. Making a successful diagnosis is contingent on a thorough understanding of epidemiology, common clinical presentations, and best testing practices for histoplasmosis. While most subclinical or self-limited diseases do not require treatment in immunocompetent patients, all immunocompromised patients and those with progressive disseminated disease or chronic pulmonary disease should be treated. Liposomal amphotericin B is the preferred agent for severe or disseminated disease, while itraconazole is adequate for milder cases and “step-down” therapy following response to amphotericin B. In this review, we discuss the current evidence-based approaches to the epidemiology, diagnosis, and management of histoplasmosis.

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“…3 At least 10 cases of histoplasmosis presenting as a neck mass have been described in the literature. 4 Most of these patients had mediastinal lymph node involvement in addition to cervical lymph node involvement. Cutaneous fistula tracts complicated 6 of these published cases.…”

Section: Published Casesmentioning

confidence: 99%

“…Cutaneous fistula tracts complicated 6 of these published cases. 4 Six cases were diagnosed surgically, and 2 were diagnosed by results of fineneedle aspiration biopsy. 4 Histoplasma infection has also been reported, in rare instances, to cause neck abscess, 5 infection of the thyroid gland, 6 and lingual mucosal ulceration.…”

Section: Published Casesmentioning

confidence: 99%