SURGICAL ASPECTS OF HISTOPLASMOSIS.

Abstract

There have been relatively few reported studies of the surgical removal of local lesions of histoplasmosis as described by Gryboski¹and associates in the October issue of the<i>Archives of Surgery</i>. This report concerns 51 cases of proved pulmonary and mediastinal histoplasmosis studied over a five-year period. Forty of the cases were diagnosed only by means of the Gomori methenamine silver stain. The series included 34 males and 17 females, ranging in age from 21/2 to 72 years. Twenty-two were asymptomatic at the time of surgical exploration and had no previous history of respiratory infection. In the other cases, cough was the most common symptom; chest pain, hemoptysis, and dyspnea were also noted. In 30 cases the histoplasmin skin test was positive, and in 16 cases the intermediate purified protein derivative was positive. Cavities, nonresolving infiltrative lesions, middle-lobe syndrome, and mediastinal lymphadenopathy exemplified the protean pattern of this disease.