Question

Healing with calcification is a feature of

• A. Cryptococcosis
• B. Mucormycosis
• C. Aspergillosis
• D. Histoplasmosis

Hint:

Think of the fungal infection that mimics tuberculosis in its healing pattern.

Answer 1

The Correct Option is D

The question wants to know which fungus, once its lesions heal, leaves calcification behind, a pattern similar to old healed tuberculosis.

1. Cryptococcosis: forms soft, mucoid or gelatinous lesions with a weak fibrous reaction, and is mostly remembered for meningitis in immunocompromised people rather than calcified scars.
2. Mucormycosis: is an aggressive, blood vessel invading infection that causes tissue death quickly. It does not slow down enough to heal by calcification, and is often life threatening.
3. Aspergillosis: either sits as a fungus ball, an aspergilloma, inside an old cavity, or invades tissue causing necrosis and bleeding in the sick host. Calcified healed scars are not its typical picture.
4. Histoplasmosis: behaves much like tuberculosis. Small granulomas form in the lung, spleen and liver, and as they heal they fibrose and then calcify, giving the classic multiple tiny calcified spots seen on imaging.

Only histoplasmosis follows the slow granuloma to fibrosis to calcification sequence that produces healed calcified lesions.

Let's summarize:

• Calcified healing needs a slow, granulomatous immune response, the same pattern tuberculosis shows.
• Histoplasmosis mimics tuberculosis in this exact way, while the other three fungi cause acute necrosis or non calcifying lesions.

So histoplasmosis is the fungal infection that classically heals with calcification.