Fibrosing Mediastinitis Caused by Histoplasmosis in an Adolescent

Madhusudan Ganigara, MD; John J. Flores, MD; Jeremy Slivnick, MD; Luis Landeras, MD; Narutoshi Hibino, MD, PhD; Barbara Hendrickson, MD; Aliya Husain, MD; Luca Vricella, MD; Michael G. Earing, MD

JACC: Case Reports (Jan 2024)

Fibrosing Mediastinitis Caused by Histoplasmosis in an Adolescent

Madhusudan Ganigara, MD,
John J. Flores, MD,
Jeremy Slivnick, MD,
Luis Landeras, MD,
Narutoshi Hibino, MD, PhD,
Barbara Hendrickson, MD,
Aliya Husain, MD,
Luca Vricella, MD,
Michael G. Earing, MD

Affiliations

Madhusudan Ganigara, MD: Division of Cardiology, Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA; Address for correspondence: Dr Madhusudan Ganigara, The University of Chicago and Biological Sciences, 5841 S Maryland Avenue, Chicago, Illinois 60637, USA.
John J. Flores, MD: Division of Infectious Diseases, Department of Pediatric and Adult Medicine, The University of Chicago, Chicago, Illinois, USA
Jeremy Slivnick, MD: Division of Cardiology, Department of Medicine, The University of Chicago, Chicago, Illinois, USA
Luis Landeras, MD: Division of Radiology, The University of Chicago, Chicago, Illinois, USA
Narutoshi Hibino, MD, PhD: Division of Cardiac Surgery, Department of Surgery, The University of Chicago, Chicago, Illinois, USA
Barbara Hendrickson, MD: Division of Infectious Diseases, Department of Pediatric and Adult Medicine, The University of Chicago, Chicago, Illinois, USA
Aliya Husain, MD: Division of Pathology, The University of Chicago, Chicago, Illinois, USA
Luca Vricella, MD: Division of Cardiac Surgery, Department of Surgery, The University of Chicago, Chicago, Illinois, USA
Michael G. Earing, MD: Division of Cardiology, Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA; Division of Cardiology, Department of Medicine, The University of Chicago, Chicago, Illinois, USA

Journal volume & issue: Vol. 29, no. 2
p. 102161

Abstract

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Fibrosing mediastinitis (FM) is a rare, potentially progressive disease resulting from an idiosyncratic immune response to a variety of stimuli that lead to fibrous infiltration of the mediastinum and possible narrowing of the bronchovascular structures. We report an unusual case of FM in a pediatric patient presenting as myopericarditis and progressing to pericardial thickening and encasement of the mediastinal vascular structures needing surgical intervention. Imaging, including transthoracic echocardiography, cardiac computed tomography, and cardiac magnetic resonance played a crucial role in the diagnosis, assessment, and follow-up. Contrast-enhanced computed tomography can be especially helpful to demonstrate potential findings associated with FM.

Published in JACC: Case Reports

ISSN: 2666-0849 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jacc-case-reports

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Abstract

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