The Systemic Mycoses in Differential Diagnosis of Chronic Pulmonary Disease

¹ Hospital Director and Assistant Clinical Professor of Medicine, University of Louisville School of Medicine

Tuberculosis control is yet to be achieved, and at the same time, fungus diseases are playing a greater role in chronic respiratory disease.

Some of the important systemic mycoses with pulmonary involvement are mentioned, and particular reference is made to histoplasmosis and blastomycosis. These are endemic in the Ohio-Mississippi region of the United States and many cases have been reported in the last few years. These can at times present serious diagnostic problems, and can simulate tuberculosis or carcinoma.

Specific examples of some of these problems are given including cases of pulmonary tuberculosis with histoplasmosis, tuberculosis with blastomycosis, exploratory thoracotomy in pulmonary histoplasmosis being complicated by histoplasmosis empyema.

The importance of accurate diagnoses is re-emphasized, and the various procedures outlined. Increased awareness is essential as treatment can be beneficial in many of these patients.