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Histoplasmosis

Reviewed 06/2019
 


BASICS

DESCRIPTION

  • A fungal infection caused by Histoplasma capsulatum, a dimorphic, soil-dwelling saprophyte, which exists as a mold in the environment and as a yeast in tissues (at 37°C)

  • Infection is ...

DIAGNOSIS

  • Primary histoplasmosis is usually asymptomatic; 99% remains subclinical.

  • 1% of immunocompetent individuals with low-level exposure develop symptoms.

HISTORY

Inquire about prior or recent travel...

TREATMENT

GENERAL MEASURES

  • Outpatient care for most cases

  • Disseminated histoplasmosis requires hospitalization for initial treatment.

  • 99% of acute primary histoplasmosis resolves spontaneously (symptomat...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Renal function and liver chemistries every 1 to 2 months for patients on chronic medical therapy

  • Serial chest x-ray to evaluate response to thera...

REFERENCES

1
Kauffman CA. Histoplasmosis: a clinical and laboratory update. Clin Microbiol Rev.  2007;20(1):115–132. [View Abstract on OvidMedline]
2
Wheat LJ, Freifeld AG, Kleiman MB, et al; for In...

ADDITIONAL READING

  • Evrard S, Caprasse P, Gavage P, et al. Disseminated histoplasmosis: case report and review of the literature. Acta Clin Belg.  2018;73(5):356–363. [View Abstract on OvidMedline...

CODES

ICD10

  • B39.9 Histoplasmosis, unspecified

  • B39.4 Histoplasmosis capsulati, unspecified

  • B39.1 Chronic pulmonary histoplasmosis capsulati

  • B39.3 Disseminated histoplasmosis capsulati

  • B39.2 Pulmonary histop...

CLINICAL PEARLS

  • Most primary histoplasmosis infections are asymptomatic and resolve spontaneously.

  • ~1% of immunocompetent individuals with low-level exposure develop symptoms.

  • Serology may be negative i...

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