Histoplasmosis

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Contents 1 More Specific Terms 2 Introduction 3 Pathology 4 Clinical-manifestations 5 Laboratory 6 Radiology 7 Management 8 More General Terms 9 Additional Terms 10 References

More Specific Terms

• histoplasmosis skin testing

Introduction

• Infection caused by Histoplasma capsulatum. Largely a disease associated with AIDS.

Pathology

• disseminated disease commonly involves the lungs, liver, spleen, lymph nodes, bone marrow, & central nervous system,
• eye may be involved [3]

Clinical-manifestations

• patients may be asymptomatic
• pulmonary

• cough
• dyspnea
• rales

• gastrointestinal

• abdominal cramps
• diarrhea
• melena
• obstruction
• bowel perforation

• meningitis
• malaise
• weight loss
• fever
• ulcers on tongue & lips
• lymphadenopathy
• splenomegaly
• hepatomegaly

Laboratory

• culture of organisms from:

• blood
• sputum
• mouth
• bone marrow
• urine
• cerebrospinal fluid ( CSF)

• increasing complement fixation titer
• antigen measurement from:

• blood
• urine
• cerebrospinal fluid

• positive skin testing

Radiology

• pneumonitis
• calcified lesions in later phases of disease

Management

• mild forma may not require antifungal therpay
• amphotericin B 0.5-0.6 mg/kg/day for several weeks for severe infection
• itraconazole

• 200 mg PO BID for mild-moderate infection
• 200 mg PO QD for lifelong suppression (98% effective)

• fluconazole is less effective than itraconazole

• up to 800 mg/day is required for 74% suppression

More General Terms

• mycosis; fungal infection

Additional Terms

• Histoplasma capsulatum
• histoplasmin (Histolyn-CYL)

References

1. DeGowin & DeGowin's Diagnostic Examination, 6th edition, RL DeGowin (ed), McGraw Hill, NY 1994, pg 895
2. Medical Knowledge Self Assessment Program (MKSAP) 11, 15, American College of Physicians, Philadelphia 1998, 2009
3. National Eye Institue: Ocular Histoplasmosis [1]
4. National Guideline Clearinghouse Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. ngc-guideline: [2]

histoplasmosis