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April 1965

Primary Pulmonary Histoplasmosis: Associated Pericardial and Mediastinal Manifestations

Am J Dis Child. 1965;109(4):298-303. doi:10.1001/archpedi.1965.02090020300006

Introduction  PRIMARY infection with Histoplasma capsulatum is almost always a benign subclinical episode that can be occasionally documented in adults who have recently moved into the endemic area from areas where infection is uncommon. In native residents of the endemic area, primary infection occurs most frequently in childhood and is seldom clinically manifest. Skin test and autopsy surveys1-3 have documented the frequency of primary infection in childhood.The awareness of the various clinical manifestations of histoplasmosis has led to increased recognition of infection with H capsulatum, especially in children. Of particular interest has been the almost invariable occurrence of prinary dissemination which is almost always benign.4,5The hilar component of the histoplasmic primary complex may be striking in size, someimes disproportionate to the size of the parenchymal foci. These hilar and mediastinal nasses may cause a wide variety of syndromes related to their anatomical location.4,6-8Involvement of