An adolescent with asthma presenting with worsening cough
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Joshua P. Brickner
und
Aneesh K. Tosh
Abstract
The diagnosis of systemic histoplasmosis may be delayed due to underlying pulmonary conditions in patients from an endemic area. An adolescent White male from the Midwestern United States with a history of moderate persistent asthma presented to the pulmonary clinic with a 10-day’s history of cough. The patient had no response to modifications of his asthma treatment regimen and proceeded to experience worsening symptoms, including pleuritic chest pain and dysphagia. Chest imaging revealed multiple pulmonary nodules, right mainstem bronchus narrowing, bilateral hilar adenopathy, and esophageal thickening. Ophthalmologic examination revealed an ocular “histo spot”, but the patient denied any ocular symptoms. Despite negative initial histoplasmosis antibody testing, the patient began oral itraconazole therapy for presumed histoplasmosis infection. Follow-up histoplasmosis antibody titers were positive, and the patient responded well to itraconazole. Disseminated histoplasmosis can have a wide range of presenting symptoms, which may delay its diagnosis among patients with pre-existing asthma.
References
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©2015 by De Gruyter
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- Frontmatter
- Editorial
- Traumatic brain injury: some good news
- Mini Review
- Premenstrual disorder and the adolescent: clinical case report, literature review, and diagnostic and therapeutic challenges
- Original articles
- The relationship between physical fitness and obesity among a sample of adolescents in Cyprus
- Exposing young people to cooking and new foods: findings from a feasibility study in an alternative education setting
- Prolonged rooming-in in infancy is associated with generalized anxiety disorder in the adolescent period
- Prevalence of bullying in secondary schools in Port Harcourt
- Prevalence and determinants of smoking initiation among school students in Bosnia and Herzegovina
- Effects of lifetime tobacco, alcohol and drug use on psychological and behavioral problems among 10th grade students in Istanbul
- Internal resilience, peer victimization, and suicidal ideation among adolescents
- Predictors of violence and depression: the case of adolescents in Turkey
- Barriers to health education in adolescents: health care providers’ perspectives compared to high school adolescents
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- Age at menarche and diet among adolescents in slums of Nashik, India
- Case Reports
- Charging of the penis: an unusual method for sexual gratification
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- Short Communication
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- Letter to the Editor
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