- This is a disease caused by the
fungus Histoplasma capsulatum. In the United States it
is most commonly found in the central and eastern
states. It can also be found in Africa, Southeast
Asia, Canada, Mexico, Central America and South America.
- The fungus has two separate
physical forms: one that is inhaled, called conidia; and a
second, which results from converting the aerosol form to
budding cells in the lungs. From here, the fungus
spreads through the bloodstream. Most cases of
Histoplasmosis do not cause symptoms or cause a mild
flu-like illness (cough, body aches, etc.) lasting 1-15
days, depending on severity. There are four types of
Histoplasmosis infections that cause more severe syndromes
- Chest X-Ray may show focal Pneumonia, progressive changes especially in the apices of the lungs, or a miliary pattern depending on the clinical syndrome.
- Anemia or chronic disease is usually present in those with chronic lung disease
- Bone marrow biopsy may show infection in disseminated disease
- Alkaline phosphatase, LDH, and ferritin levels may be elevated
- Urine antigen assay is 90% sensitive for diagnosing disseminated disease
- Complement fixation titers in the serum are 80% sensitive for lung disease
- Progressive localized disease and mild-moderate disease -- Itraconazole orally. Amphotericin B intravenously is used for those who fail treatment.
- Severe or disseminated disease -- intravenous amphotericin B. Patients with AIDS and Histoplasmosis need life-long suppressive therapy with oral Itraconazole after treatment with intravenous Amphotericin.
- Acute Histoplasmosis -- person is very ill and has
fever, but minimal lung complaints (even if a
Histoplasmosis Pneumonia is present). Usually
lasts 1 week to six months, but is almost never fatal.
- Progressive disseminated Histoplasmosis -- cough,
shortness of breath, fever, person feels very ill, loss of
weight, and liver, spleen and adrenal glands are usually
enlarged. There may be ulcers in the mouth. This
syndrome can be fatal within six weeks especially without
- Chronic progressive pulmonary Histoplasmosis --
usually occurs in older patients with COPD (Emphysema or
chronic Bronchitis). It causes progressive lung
- Disseminated disease in immunocompromised patients
(e.g., on chemotherapy or has AIDS) -- person has fever and the
Histoplasmosis can affect many different organs, including
the meninges (causing Meningitis). The chest X-Ray may show a diffuse pattern of
involvement (miliary pattern). Patients come to the
hospital in shock. Death usually occurs rapidly
If you want your friend to read or know about this article, Click here