Factor Treatment of Bronchial Obstruction after Lung

was remarkable and suggests an underlying immunologic disorder, although we were unable to define a specffic immunologic defect. This patient demonstrates that excessive fibrosis from H capsulatum infection can occur not only in the mediastinum, pencardium, and pleura, but also in the epicardium. Recurrent massive pleural effusions may occur. Histoplasmosis is not currently listed as a possible etiology for pleural effusions,’ but it should be included in the differential diagnosis in riew of our findings. Congestive heart failure refractory to medical or surgical therapy can occur as a result ofepicardial fibrosis.