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Histoplasmosis

Sanu s Rajendraprasad, MD Reviewed 06/2022
 


BASICS

Histoplasmosis is the most prevalent endemic mycosis in the United States  and worldwide it is most common among people who have HIV/AIDS or a weakened immune system (1).  

DESCRIPTION

  • A fungal ...

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
Tobón AM, Gómez BL. Pulmonary histoplasmosis. Mycopathologi. 2021;186(5):695–705. doi: 10.1007/s11046-021-00588-4.
2
Hage CA, Bowyer S, Tarvin SE, et al. Recognition, diagnosis, and treatmen...

ADDITIONAL READING

Kunin JR, Flors L, Hamid A, et al. Thoracic endemic fungi in the United States: importance of patient location. Radiographics. 2021;41(2):380–398. doi: 10.1148/...

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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