2,992
回編集
差分
ナビゲーションに移動
検索に移動
→disease
==Histoplasmosis==
===pathogen===
*''Histoplasma capsulatum'' var. ''capsulatum''
*soil habitant fungus
*dimorphic fungi
===transmission===
*inhalation of fungus containing soil, bird excreta, bat guano
===risk===
*occupational, building cleaning
*cave exploration (spelunking)
*cell-mediated immunocompromised
**HIV
**anti-TNF inhibitors
**other immunosupression
===distribution===
*Latin America
*eastern part of north America
*sub-Saharan Africa
*Nepal - Bangradesh - Indochina peninsula
===disease===
*acute pneumonia
**disseminated consolidations in both lungs
*mediastinal lymphadenopathy
**DDx: TB, sarcoidosis, lymphoma
*chronic lung cavity
**associated with smoking/COPD
**DDx: TB, aspergillosis
*progressive disseminated histoplasmosis
**risk at HIV CD4<150
===diagnosis===
*culture on Sabouraud's agar
**4-8 weeks
*serology
*antigen test in urine
===treatment===
*liposomal amphotericin B
*itraconazole
