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Histoplasmosis - chronic pulmonaryDefinition Chronic pulmonary histoplasmosis is a respiratory infection caused by the fungus Histoplasma capsulatum. Causes, incidence, and risk factors Histoplasma capsulatum is a fungus found in the soil of the central and eastern United States (especially Mississippi and Ohio river valleys), eastern Canada, Mexico, Central America, and South America. The infection occurs when a person breaths in the reproducing parts of the fungus, called spores. Those with healthy immune systems usually do not have symptoms, or only mild ones. This "acute" infection does not persist. However, the infection can linger in those with lung problems such as smokers with emphysema or chronic obstructive pulmonary disease ( COPD). This condition is called "chronic" pulmonary histoplasmosis. The symptoms and chest x-ray findings of chronic pulmonary histoplasmosis are similar to tuberculosis. Risk factors for chronic pulmonary histoplasmosis include:
Symptoms
Signs and tests Tests that may be used in the diagnosis of chronic pulmonary histoplasmosis include:
Treatment Antifungal medications are prescribed to control the infection within the lung. Itraconazole (by mouth) or amphotericin B (intravenously) is usually successful. Expectations (prognosis) The infection usually goes away with antifungal medication, but scarring inside the lung often remains. Many patients will still be sick due to their pre-existing lung disease. Often times, those who have had chronic pulmonary histoplasmosis must follow up with their doctor, who will check for signs of relapse. In rare cases, a pulmonary histoplasmosis infection can spread through the blood to other organs. This is called disseminated histoplasmosis. People who have suppressed immune systems and very young children are more likely to develop this condition. If this occurs, the prognosis is less favorable. Complications
Calling your health care provider Call for an appointment with your health care provider if symptoms of chronic pulmonary histoplasmosis develop. Call your health care provider if symptoms continue despite treatment, or if breathing difficulty or symptoms of disseminated histoplasmosis occur. Prevention Avoiding travel to areas where Histoplasma capsulatum is found would prevent exposure, but this may not be practical. Avoid bird or bat droppings if you are in one of these areas, especially if you are immunosuppressed. Illustrations
Page Content: Chronic cavitary histoplasmosis |
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