Potential association between calcified thoracic lymphadenopathy due to previous Histoplasma capsulatum infection and pulmonary Mycobacterium avium complex disease
Chan, E.D.; Iseman, M.D.
Southern Medical Journal 92(6): 572-576
1999
ISSN/ISBN: 0038-4348 PMID: 10372850 Document Number: 503358
The frequency of calcified lymphadenopathy in the chest and prevalence of known risk factors for M. avium complex (MAC) infection were retrospectively studied in 79 patients with pulmonary MAC disease who were referred to the National Jewish Medical and Research Center, Denver, CO, USA, during January-December 1993. Calcified intrathoracic adenopathy was present in 25 of the 79 patients (32%). Residential histories revealed that 20 of the 25 patients (80%) with such calcified chest adenopathy reported living for substantial periods in the regions indigenous for H. capsulatum. In contrast, the residences of patients without calcified chest adenopathy were more evenly distributed throughout the country. 19 of these 25 patients (76%) with calcified chest adenopathy had no known predisposing risk factor for the infection; in contrast, the proportion of patients with no calcified adenopathy who also had no identifiable classic risk factor tended to be lower (32 of 54, 59%). It is concluded that previous fungal infection may predispose the lungs of certain patients to subsequent invasion by MAC, presumably by airway distortion and/or parenchymal damage.