{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:26:28Z","timestamp":1765545988411,"version":"3.46.0"},"reference-count":5,"publisher":"Walter de Gruyter GmbH","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The diagnosis of systemic histoplasmosis may be delayed due to underlying pulmonary conditions in patients from an endemic area. An adolescent White male from the Midwestern United States with a history of moderate persistent asthma presented to the pulmonary clinic with a 10-day\u2019s history of cough. The patient had no response to modifications of his asthma treatment regimen and proceeded to experience worsening symptoms, including pleuritic chest pain and dysphagia. Chest imaging revealed multiple pulmonary nodules, right mainstem bronchus narrowing, bilateral hilar adenopathy, and esophageal thickening. Ophthalmologic examination revealed an ocular \u201chisto spot\u201d, but the patient denied any ocular symptoms. Despite negative initial histoplasmosis antibody testing, the patient began oral itraconazole therapy for presumed histoplasmosis infection. Follow-up histoplasmosis antibody titers were positive, and the patient responded well to itraconazole. Disseminated histoplasmosis can have a wide range of presenting symptoms, which may delay its diagnosis among patients with pre-existing asthma.<\/jats:p>","DOI":"10.1515\/ijamh-2014-0046","type":"journal-article","created":{"date-parts":[[2014,12,16]],"date-time":"2014-12-16T05:06:50Z","timestamp":1418706410000},"page":"459-461","source":"Crossref","is-referenced-by-count":1,"title":["An adolescent with asthma presenting with worsening cough"],"prefix":"10.1515","volume":"27","author":[{"given":"Joshua P.","family":"Brickner","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Lake Regional Hospital, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph E.","family":"Muenster","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor H.","family":"Pancoast","sequence":"additional","affiliation":[{"name":"University of Missouri School of Medicine, Department of Child Health, Columbia, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aneesh K.","family":"Tosh","sequence":"additional","affiliation":[{"name":"University of Missouri School of Medicine, Department of Child Health, Columbia, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2014,12,16]]},"reference":[{"key":"2025112800244742086_j_ijamh-2014-0046_ref_001_w2aab2b8c15b1b7b1ab2ab1Aa","doi-asserted-by":"crossref","unstructured":"Wheat LJ, Freifield AG, Kleiman MB, Baddley JW, McKinsey DS, et al. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin Inf Dis 2007;45:807\u201325.10.1086\/52125917806045","DOI":"10.1086\/521259"},{"key":"2025112800244742086_j_ijamh-2014-0046_ref_002_w2aab2b8c15b1b7b1ab2ab2Aa","unstructured":"Fletcher EC, Chong NHV, Shetlar DJ. Retina. In: Riordan-Eva P, Whitcher JP, editors. Vaughan and Asbury\u2019s general ophthalmology. New York, NY: Lange Medical Publications; 2007:186\u2013211."},{"key":"2025112800244742086_j_ijamh-2014-0046_ref_003_w2aab2b8c15b1b7b1ab2ab3Aa","unstructured":"Coats DK, Carothers TS, Brady-McCreery K, Paysse EA. Ocular infectious diseases. In: Feigin RD, Cherry J, Demmler G, Kaplan S, editors. Textbook of pediatric infectious diseases. Philadelphia, PA: Saunders, 2004:787\u2013809."},{"key":"2025112800244742086_j_ijamh-2014-0046_ref_004_w2aab2b8c15b1b7b1ab2ab4Aa","doi-asserted-by":"crossref","unstructured":"Wheat LJ. Approach to the diagnosis of the endemic mycoses. Clin Chest Med 2009;30:379\u201389.10.1016\/j.ccm.2009.02.01119375642","DOI":"10.1016\/j.ccm.2009.02.011"},{"key":"2025112800244742086_j_ijamh-2014-0046_ref_005_w2aab2b8c15b1b7b1ab2ab5Aa","doi-asserted-by":"crossref","unstructured":"Wheat LJ. Improvements in diagnosis of histoplamosis. 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