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Histoplasmosis  

• Caused by Histoplasma Capsulatum, a soil fungus found especially in the Ohio River Valley (Ohio, Mississippi)

• Similar in course and x-ray appearance to tuberculosis

• Histoplasmosis is the most common cause of fibrosing mediastinitis

Primary histoplasmosis

• Most infections are subclinical

• X-ray

• Migratory bronchopneumonia

• Hilar and mediastinal adenopathy

• Multiple nodules which heal with numerous calcified granulomas

• TB granulomas are usually 1 or 2 in number

• Histoplasmoma=target calcification=bull’s-eye calcification in center of nodule (Pathognomonic)

Chronic histoplasmosis

• Upper lobe cavitation, healing with fibrosis (very similar to TB)

Disseminated histoplasmosis

• Infants and elderly are predisposed

• Can be rapidly fatal

• X-ray

• Consolidation

• Adenopathy

• Hepatosplenomegaly

• Multiple splenic calcifications (unusual for TB)

WH/‘93

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