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Surgical Aspects of Histoplasmosis

WILLIAM A. GRYBOSKI, MD; RICHARD R. CRUTCHER, MD; JAMES B. HOLLOWAY, MD; PORTER MAYO, MD; RICHARD H. SEGNITZ, MD; BEN EISEMAN, MD
Arch Surg. 1963;87(4):590-599. doi:10.1001/archsurg.1963.01310160052009.
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Although the pathogenesis,1,2 epidemiology,3-5 and clinical manifestations6-10 of histoplasmosis have been extensively reviewed, relatively few studies have been made of the surgical implications of this disease. Noteworthy exceptions are the reviews of Forsee,11 Takaro,12 Curry,13 Polk,14 and others.15-35 There are but 370 surgical cases in these studies in which there has been either histologic or cultural identification of the organism.

The purpose of this paper is to review the clinical experience in three private hospitals in Lexington, Ky, over a five-year period with 51 cases of proven pulmonary and mediastinal histoplasmosis. The indications for surgery are reviewed, the proven safety of conservative resection without chemotherapy demonstrated, and the benefits of the Gomori methenamine silver stain (GMS) illustrated for identification of the infecting organism.

Materials and Methods  The records of the three private hospitals * in Lexington, Ky, were reviewed for the five-year period

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