Spontaneous pneumothorax secondary to chronic cavitary pulmonary histoplasmosis

Histoplasma capsulatum is a dimorphic fungus that causes histoplasmosis. Chronic cavitary pulmonary histoplasmosis is rare, and typically manifests as apical cavitary lesions in patients with pre-existing chronic obstructive pulmonary disease. We report a case involving a 60-year-old female who pres...

Full description

Saved in:
Bibliographic Details
Published in:Journal of community hospital internal medicine perspectives 2020-09, Vol.10 (5), p.483-487
Main Authors: Geurkink, Samuel, Cler, Leslie
Format: Article
Language:English
Subjects:
Antifungal agents
Biopsy
Case Report
Case reports
cavitary
Chest
Chronic obstructive pulmonary disease
Computed tomography
Cough
Dyspnea
Fungi
Histoplasma capsulatum
Histoplasmosis
Itraconazole
Lesions
Lung diseases
Lungs
Obstructive lung disease
Ostomy
Patients
Pneumothorax
Respiration
Thorax
X-rays
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Histoplasma capsulatum is a dimorphic fungus that causes histoplasmosis. Chronic cavitary pulmonary histoplasmosis is rare, and typically manifests as apical cavitary lesions in patients with pre-existing chronic obstructive pulmonary disease. We report a case involving a 60-year-old female who presented to our facility with acute onset of dyspnea and dry cough. Chest x-ray revealed a large left-sided pneumothorax with nearly complete collapse of the left lung. A chest computed tomography scan revealed a left upper lobe cavitary lesion with a bronchopleural fistula. After thoracic surgical bleb resection, a surgical specimen sent for biopsy was positive for . The patient's pneumothorax was subsequently diagnosed as chronic cavitary pulmonary histoplasmosis, and itraconazole treatment was initiated. After admission, the patient underwent a thoracotomy with decortication to improve lung expansion; however, the patient's pneumothorax persisted. After a prolonged hospital stay and serial chest x-rays that showed stable residual pneumothorax, the patient was discharged to a long-term acute care facility and itraconazole treatment was continued. Two months after discharge, a repeat chest x-ray showed resolution of her left-sided pneumothorax. This case report highlights the importance of considering pulmonary histoplasmosis (or other endemic pulmonary fungal infections) when a patient presents with apical cavitary lesions.
ISSN:2000-9666
2000-9666
DOI:10.1080/20009666.2020.1797285