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Healthy You

Patient Praises at the Top of His Lungs

Monday, November 26, 2018 9:37 AM

Greg Taylor was blindsided. Active and athletic, Taylor did not know what hit him after a mysterious illness left him fatigued and in severe pain. He dropped 50 pounds, and on some days could barely get out of bed. Then, the 42-year-old began having difficulty speaking and had to take leave from his job in youth sports at Evanston’s McGaw YMCA.

Otolaryngology

Quest for Answers
Understandably worried, Taylor made an appointment with NorthShore Otolaryngologist Steven Horwitz, MD, who determined that Taylor’s left vocal cord was paralyzed. Dr. Horwitz ordered an MRI that revealed a large mass in his chest, and a follow-up CT scan found that the mass was wrapped around the root of the left lung. These images raised frightening possibilities: lymphoma or lung cancer.

“It sounded scary, but I was in so much pain that if it was a cancer diagnosis, I was optimistic I could beat it,” recalled Taylor. “I was just thinking let’s get on to treatment, recovery and normalcy. I honestly just wanted to feel better.”

Dr. Horwitz referred Taylor to a pair of NorthShore specialists: Pulmonologist Curtis Weiss, MD, and Thoracic Surgeon Seth Krantz, MD. Dr. Krantz performed a minimally invasive surgical biopsy of Taylor’s chest mass and came back with good news: it did not appear to be cancerous. But his physician team still needed to identify the underlying cause of Taylor’s symptoms and the reason for the growth of the masses, which had become large enough to impede his lung function and major arteries.

“I was concerned that Greg had a very rare condition that causes scarring internally in the chest, called fibrosing mediastinitis, which causes patients to develop scar tissue that can compromise breathing,” said Dr. Krantz, who holds an academic appointment at the University of Chicago Pritzker School of Medicine. “We were determined to figure this out as quickly as possible.”

Collaboration with Mayo Clinic
Dr. Krantz had a hunch that the scarring could be in response to an infection called histoplasmosis, caused by inhaling microscopic fungal spores that can come from the soil or even bird or bat droppings. Typically, patients with histoplasmosis show no symptoms, but in rare circumstances it can cause severe complications.

Due to the highly complex nature of Taylor’s condition, Drs. Krantz and Weiss took advantage of NorthShore’s ongoing participation in the Mayo Clinic Care Network, and consulted with Mayo Clinic Pulmonologist Teng Moua, MD. Initially, the three specialists agreed on a follow-up biopsy, which again showed no sign of cancer. 

As part of the Mayo Clinic collaboration, Taylor’s NorthShore care team facilitated a visit to Minnesota so Dr. Moua could examine Taylor personally. He confirmed Dr. Krantz’s diagnosis of a severe immunologic response to the fungal invasion.

“Greg’s immune system was in overdrive, and the result was all of this scar tissue throughout his abdomen, which, if not addressed, could be life-threatening,” explained Dr. Moua. “Thankfully, our relationship with NorthShore created the opportunity to work together on this complicated case resulting in a positive outcome.”

In continuing collaboration with Drs. Krantz and Weiss, Dr. Moua placed Taylor on a set of medications including a high-dose antifungal.

“The treatment worked,” exclaimed Taylor. “I’ve done a complete 180 in the way I feel! My energy and appetite are back. The pain is gone; no more headaches and backaches and chest pain. I’m sleeping now and have started to put the weight back on.”

Taylor also returned to work at the “Y.” “I’m coaching basketball again and was even doing push-ups with the team the other day,” he added. “I feel great! It’s amazing and I’m so grateful to NorthShore, the doctors there and that they were able to arrange the consultation with Mayo Clinic. I don’t know where I’d be without them.”