Surgical aspects of pulmonary histoplasmosis. A series of 110 cases

Thorax. 1970 Jan;25(1):31-40. doi: 10.1136/thx.25.1.31.

Abstract

Histoplasmosis is of special interest to thoracic surgeons because it may appear in such a wide variety of clinical forms. Fourteen years' experience with 110 proved cases of surgically treated pulmonary histoplasmosis has been reviewed. Twenty-one of these patients manifested as `coinlesion' and underwent only wedge resection without amphotericin B therapy. A long-term follow-up of these patients indicates that these lesions are benign and need no additional therapy. Thirteen patients with pulmonary infiltration underwent surgery and three received post-operative amphotericin B therapy. Our largest group of surgically treated patients is of cavitary histoplasmosis. There were 76 patients in this group; 38 were managed with only surgical resection and the other 38 had surgical resection together with amphotericin B therapy. Operative indications, various forms of treatment, post-operative complications, and their results have been critically analysed. From this study we conclude that amphotericin B offers little protection against the immediate post-operative complications, but it reduces mortality and a recurrence of the disease, as judged from long-term follow-up.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amphotericin B / therapeutic use
  • Female
  • Follow-Up Studies
  • Histoplasmosis / diagnostic imaging
  • Histoplasmosis / drug therapy
  • Histoplasmosis / epidemiology
  • Histoplasmosis / mortality
  • Histoplasmosis / surgery*
  • Humans
  • Lung Diseases, Fungal / surgery*
  • Male
  • Middle Aged
  • Postoperative Care
  • Postoperative Complications
  • Radiography
  • Solitary Pulmonary Nodule / surgery

Substances

  • Amphotericin B