Histoplasmosis

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Lungs

Acute histoplasmosis

Disseminated histoplasmosis

Histoplasmosis, disseminated in HIV patient

Overview

Symptoms

Treatment

Prevention

Histoplasmosis

Alternative Names:

Ohio River Valley fever

Treatment:

The mainstay of therapy for histoplasmosis is antifungal therapy. In the case of pulmonary histoplasmosis, this may include oral agents such as itraconazole or ketoconazole. In disseminated disease -- particularly meningitis -- therapy with intravenous amphotericin is used followed by long-term suppression with an oral agent such as itraconazole.

Expectations (prognosis):

Prognosis depends on the clinical syndrome -- mortality is highest in disseminated histoplasmosis (up to 80% without treatment -- decreased to 25% with treatment).

Complications:

Inflammatory syndromes involving heart lining (pericarditis)
- joints (arthritis)
- skin nodules
- rashes (erythema nodosum, erythema multiforme)
Fibrosing mediastinitis -- scarring in the chest that may entrap structures in the chest cavity:
- lymph nodes
- heart
- great vessels
- esophagus
Mediastinal granuloma -- enlarged chest-cavity lymph nodes which may compress structures such as esophagus and lung vessels

In individuals with weakened immune systems disseminated disease may occur and involve the meninges (meningitis)

Side effects of medications (can be severe with amphotericin) are complications of histoplasmosis.

Calling your health care provider:

Notify your medical provider if you live in an endemic area for histoplasmosis and you develop flu-like symptoms, chest pain, cough and shortness of breath. While there are many other illnesses that may have similar symptoms, you may need to be evaluated for the possibility of histoplasmosis.

Review Date: 7/16/2004
Reviewed By: Daniel Levy, M.D., Ph.D., Infectious Diseases, Greater Baltimore Medical Center, Baltimore, MD. Review provided by VeriMed Healthcare Network.

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