ro13-9904 and Esophageal-Fistula

A 41-year-old man was admitted for evaluation of hemoptysis, dysphagia, and pleuritic chest pain associated with a mediastinal mass. Esophagography demonstrated a fistula between the mass and the esophagus. Results of histoplasmosis complement fixation serologic testing suggested an active infection. A methenamine silver stain of a lymph node obtained at mediastinoscopy revealed Histoplasmosis capsulatum. The patient was successfully treated with amphotericin B. This is believed to be the first reported case of an esophageal fistula as a complication of mediastinal histoplasmosis successfully treated with amphotericin B.

Topics: Adult; Amphotericin B; Ceftriaxone; Drug Therapy, Combination; Esophageal Fistula; Hemoptysis; Histoplasmosis; Humans; Male; Mediastinal Diseases; Metronidazole