Fibrosing Mediastinitis Caused by Histoplasmosis in an Adolescent

• Published in: JACC: Case Reports
• Main Authors: Madhusudan Ganigara, MD, John J. Flores, MD, Jeremy Slivnick, MD, Luis Landeras, MD, Narutoshi Hibino, MD, PhD, Barbara Hendrickson, MD, Aliya Husain, MD, Luca Vricella, MD, Michael G. Earing, MD
• Format: Article
• Language: English
• Published: Elsevier 2024-01-01
• Subjects: fibrosing mediastinitis; myopericarditis; pediatrics
• Online Access: http://www.sciencedirect.com/science/article/pii/S266608492300517X
• ISSN: 2666-0849

Fibrosing mediastinitis (FM) is a rare, potentially progressive disease resulting from an idiosyncratic immune response to a variety of stimuli that lead to fibrous infiltration of the mediastinum and possible narrowing of the bronchovascular structures. We report an unusual case of FM in a pediatric patient presenting as myopericarditis and progressing to pericardial thickening and encasement of the mediastinal vascular structures needing surgical intervention. Imaging, including transthoracic echocardiography, cardiac computed tomography, and cardiac magnetic resonance played a crucial role in the diagnosis, assessment, and follow-up. Contrast-enhanced computed tomography can be especially helpful to demonstrate potential findings associated with FM.