Esophageal fistula complicating mediastinal histoplasmosis. Response to amphotericin B.
A 41-year-old man was admitted for evaluation of hemoptysis, dysphagia, and pleuritic chest pain associated with a mediastinal mass. Esophagography demonstrated a fistula between the mass and the esophagus. Results of histoplasmosis complement fixation serologic testing suggested an active infection. A methenamine silver stain of a lymph node obtained at mediastinoscopy revealed Histoplasmosis capsulatum. The patient was successfully treated with amphotericin B. This is believed to be the first reported case of an esophageal fistula as a complication of mediastinal histoplasmosis successfully treated with amphotericin B.
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004937:Esophageal Fistula / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006469:Hemoptysis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D006660:Histoplasmosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008795:Metronidazole / Q000627:therapeutic use
D008795:Metronidazole; D002443:Ceftriaxone; D000666:Amphotericin B