Histoplasmosis presenting as a mediastinal mass

Pulmonary histoplasmosis is caused by infection with Histoplasma capsulatum, resulting in a variety of clinical manifestations. We describe a case of an asymptomatic mediastinal mass and calcified pulmonary nodules discovered in immunocompetent child from the Southeastern United States. In the setting of inconclusive noninvasive diagnostic tests and the inability to completely exclude malignancy, the patient was taken to the operating room for excisional biopsy of the mass and right upper lobe lung nodules. A diagnosis of histoplasmosis with mediastinal granulomas was established. The patient was subsequently treated with itraconazole. This article underscores the importance of including endemic mycoses in the differential for mediastinal mass and discusses the utility of surgical intervention for the diagnosis and treatment of histoplasmosis. Keywords: Histoplasmosis, Mediastinal mass, Cryptococcu

Azygos vein erosion: A potential complication of central venous access

Central venous access is a common procedure that is performed for a variety of reasons. However, occasionally these lines can be misplaced at an improper anatomic location despite fluoroscopic guidance. Here we present a pediatric case in which a central venous port appeared correctly located on anterior-posterior (AP) fluoroscopic view. However, it was later discovered on lateral views that the catheter was placed in the azygos vein. The catheter eroded through the azygos vein and into the pleural space. This article highlights the importance of proper technique when placing central lines and discusses additional techniques and avenues of research in order to prevent this complication in the future. Keywords: Central venous access, Complications, Azygos vei