SHM Converge Scientific Abstract ePoster Gallery-When a Case of Histoplasmosis Sticks Around

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This case report describes a 21-year-old immunocompetent woman who presented with 4 days of dyspnea, cough, sweating, and subjective weight loss. Initial chest imaging showed a left suprahilar consolidation suspicious for a mass, and CT demonstrated a 7.1 × 3.9 × 2.7 cm left suprahilar lesion encasing left upper lobe vasculature. The clinical picture raised concern for a granulomatous or malignant process.<br /><br />The report emphasizes that histoplasmosis, although often asymptomatic or mild in immunocompetent patients, can still cause persistent symptoms and radiographic abnormalities due to an inflammatory response. It is especially important to consider in patients with relevant travel or residence history in endemic regions such as the Midwest and Central United States.<br /><br />Because histoplasmosis can mimic other granulomatous diseases such as tuberculosis, sarcoidosis, and other inflammatory conditions, the case highlights the importance of thorough history-taking and early use of advanced diagnostics, including imaging and biopsy, when patients do not improve with standard treatment. Rare but serious complications such as fibrosing mediastinitis and pneumothorax may occur, making follow-up and repeat imaging important.<br /><br />The patient’s follow-up chest CT one month after hospitalization showed significant interval improvement, supporting the diagnosis of persistent histoplasmoma rather than a progressive malignant process. The case underscores that histoplasmosis should remain on the differential even in otherwise healthy patients presenting with mass-like lung lesions and respiratory symptoms.

Asset Subtitle

Jacob Lesinski

Meta Tag

Author List Jacob Lesinski, Philip Huang

Category Clinical Vignettes

Concept Histoplasmosis

Concept Travel History

Concept Residence History

Concept Histoplasma Exposure

Concept Immunocompetent Patient

Distinguished Non-Finalist

Presenter Organization Ohio State University College of Medicine

Presenting Author Jacob Lesinski

Track Adult

Keywords

histoplasmosis

immunocompetent

lung mass

granulomatous disease

chest CT

histoplasmoma

dyspnea

endemic regions

biopsy

fibrosing mediastinitis

Histoplasmosis

Travel History

Residence History

Histoplasma Exposure

Immunocompetent Patient