Pulmonary Histoplasmosis: Report of a Case Long Considered Tuberculous Improved by Acti-Dione

¹ Veterans Administration Hospital, Alexandria, Louisiana.

A case is presented who had a chronic cough following "influenza" in 1918-19 and was considered to have arrested pulmonary tuberculosis from 1925 to 1949 although acid fast bacilli were never recovered. In 1949, during the severest exacerbation he had experienced, Histoplasma capsulatum was repeatedly recovered in sputum cultures. Histoplasmin skin test was positive and coccidioidin and blastomycin were negative. The complement fixation test for histoplasmosis was positive. Right upper lobectomy was performed, although the pulmonary involvement was not entirely in this lobe.

Improvement with negative sputum and gain in weight followed prolonged treatment with Acti-dione which was effective when administered either intravenously (Upjohn) or orally (Lilly). Further investigation of Acti-dione in cases of histoplasmosis is indicated.