Histoplasmosis
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Pathogen
- Histoplasma capsulatii
- Histoplasma duboisii in Africa
- dimorphic fungus
- incubation 1-4 weeks
- recurrence/reactivation in years or even in decades
- bat and birds are reservoir
- bat guano through cave exploration is at very high risk
- chicken and pigeons
Distribution
- US
- South East Asia
- Africa
Clinical features
- acute pulmonary histoplasmosis
- most common
- mostly self-limited
- chronic pulmonary histoplasmosis
- completely different form from acute ones
- COPD at risk
- fibrosing pneumoitis
- adrenal infection causing adrenal failure
- progressive to respiratory failure
- disseminated histoplasmosis
- immunocompromised at risk
- affecting multiple organs
- ocular histoplasmosis
- chronic chorio-retinitis
- controversial whether this is truly histoplamosis or not
- African histoplasmosis by H. duboisii
- different clinical pictures from H. capsulatii
Diagnosis
- culture is not so much biohazardous
Treatment
- basically itraconazole is the first-line
- differs depending on disease forms