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KMID : 0191120180330020015
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Journal of Korean Medical Science
2018 Volume.33 No. 2 p.15 ~ p.15
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Pulmonary Histoplasmosis Identified by Video-Assisted Thoracic Surgery (VATS) Biopsy: a Case Report
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Lee Ye-Jin
Kang Hye-Rin
Song Jin-Hwa
Sin Soo-Im
Lee Sang-Min
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Abstract
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Histoplasmosis is a common endemic mycosis in North, Central, and South America, but Korea is not known as an endemic area. We treated an immunocompetent Korean patient who had histoplasmosis. A 65-year-old Korean man presented with multiple pulmonary clumps of tiny nodules in the both lungs. He had been diagnosed 40 years earlier with pulmonary tuberculosis (TB) and a fungus ball had been diagnosed 4 years earlier. He denied any history of overseas travel. The patient visited our hospital with dyspnea, blood-tinged sputum, and weight loss, which had appeared 2 months earlier. The patient underwent video-assisted thoracic surgery (VATS) lung biopsy. The biopsy sample showed necrotizing granuloma and the presence of multiple small yeast-like fungi. Tissue culture confirmed Histoplasma capsulatum, and he was finally diagnosed with pulmonary histoplasmosis. Therapy was initiated with 200 mg itraconazole orally once per day. The symptoms disappeared 1 week after the start of treatment. After 4 months, low-dose chest computed tomography showed improvement in the ground glass opacity and size of the lung lesions. In conclusion, we report a case of an immunocompetent patient who developed histoplasmosis in Korea. When a patient shows unexplainable progressive infiltrative lung lesions, histoplasmosis should be considered as one of differential diagnoses although Korea is not an endemic area.
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KEYWORD
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Histoplasma capsulatum, Pulmonary Histoplasmosis, Immunocompetent Host, Fungus Ball, Korea
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