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Surgical aspects of pulmonary histoplasmosis
  1. M. K. Sutaria,
  2. J. W. Polk1,
  3. P. Reddy,
  4. S. K. Mohanty
  1. Missouri State Sanatorium, Mount Vernon, Missouri 65712

    A series of 110 cases


    Histoplasmosis is of special interest to thoracic surgeons because it may appear in such a wide variety of clinical forms. Fourteen years' experience with 110 proved cases of surgically treated pulmonary histoplasmosis has been reviewed. Twenty-one of these patients manifested as `coinlesion' and underwent only wedge resection without amphotericin B therapy. A long-term follow-up of these patients indicates that these lesions are benign and need no additional therapy. Thirteen patients with pulmonary infiltration underwent surgery and three received post-operative amphotericin B therapy. Our largest group of surgically treated patients is of cavitary histoplasmosis. There were 76 patients in this group; 38 were managed with only surgical resection and the other 38 had surgical resection together with amphotericin B therapy. Operative indications, various forms of treatment, post-operative complications, and their results have been critically analysed. From this study we conclude that amphotericin B offers little protection against the immediate post-operative complications, but it reduces mortality and a recurrence of the disease, as judged from long-term follow-up.

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    • 1 For reprints write to John W. Polk, M.D., Chief of Surgical Service. Missouri State Sanatorium, Mt. Vernon, Missouri 65712