Histoplasmosis: Difference between revisions

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   Image          = Histoplasmosis capsulatum.jpg |
   Image          = Histoplasmosis capsulatum.jpg |
   Caption        = ''[[Histoplasma capsulatum]]''. Methenamine [[silver stain]] showing histopathologic changes in histoplasmosis. |
   Caption        = ''[[Histoplasma capsulatum]]''. Methenamine [[silver stain]] showing histopathologic changes in histoplasmosis. |
  DiseasesDB    = 5925 |
  ICD10          = {{ICD10|B|39||b|35}} |
  ICD9          = {{ICD9|115}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = 001082 |
  MeshID        = D006660 |
}}
}}
{{Histoplasmosis}}
{{Histoplasmosis}}
{{About1|Histoplasma capsulatum}}


'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


{{CMG}}
{{CMG}}; {{AE}} {{SSK}}, {{VB}}, {{PTD}}, {{AKI}}


{{SK}} Ajellomyces capsulatus; Darling disease; Darling's disease
{{SK}} Ajellomyces capsulatus; Darling's disease; Cave's disease; Ohio valley disease; Spelunker's lung.


==Overview==
==[[Histoplasmosis overview|Overview]]==


==Pathogen==
==[[Histoplasmosis historical perspective|Historical Perspective]]==
''H. capsulatum'' is found throughout the world and is [[Endemic (epidemiology)|endemic]] in certain areas of the United States, particularly in states bordering the Ohio River valley and the lower Mississippi River. (Positive histoplasmin skin tests occur in as many as 80% of the people living in areas where H. capsulatum is common, such as the eastern and central United States.) H. capsulatum grows in soil and material contaminated with bat or bird droppings. The fungus has been found in poultry house litter, caves, areas harboring bats, and in bird roosts (particularly those of starlings). The fungus is thermally dimorphic. In the environment it grows as a brownish [[mycelium]], whereas at body temperature (37°C in humans) it morphs into a [[yeast]]. The inoculum is represented principally by microconidia that, once inhaled into the [[Pulmonary alveolus|alveolar]] spaces, germinate and then transform into budding yeast cells.


[[Image:Histoplasmosis, due to the fungus Histoplasma capsulatum skin lesion 6840 lores.jpg|thumb|left|200px|Skin lesion on the upper lip due to ''Histoplasma capsulatum'' infection.]]
==[[Histoplasmosis pathophysiology|Pathophysiology]]==


==Symptoms==
==[[Histoplasma capsulatum|Causes]]==
If symptoms of histoplasmosis infection occur, they will start within 3 to 17 days after exposure; the average is 12-14 days. Most affected individuals have clinically-silent manifestations and show no apparent ill effects.<ref name=Silberberg_2007>{{cite web | title = Radiology Teaching Files: Case 224856 (Histoplasmosis) | author = Silberberg P | url = http://www.mypacs.net/cases/HISTOPLASMOSIS-224856.html}}</ref>The [[Acute (medical)|acute]] phase of histoplasmosis is characterized by non-specific respiratory symptoms, often cough or flu-like. [[Chest X-ray]] findings are normal in 40-70% of cases.<ref name=Silberberg_2007 /> Chronic histoplasmosis cases can  resemble [[tuberculosis]]; disseminated histoplasmosis affects multiple organ systems and is fatal unless treated.


While histoplasmosis is the most common cause of fibrosing [[mediastinitis]], this remains a relatively rare disease.  Severe infections can cause [[hepatosplenomegaly]], [[lymphadenopathy]], and adrenal enlargement.  Lesions have a tendency to ''calcify'' as they heal.
==[[Histoplasmosis differential diagnosis|Differentiating Histoplasmosis from other Diseases]]==


[[Presumed ocular histoplasmosis syndrome|Ocular histoplasmosis]] damages the retina of the eyes.  Scar tissue is left on the retina which can experience leakage, resulting in a loss of vision not unlike [[macular degeneration]].
==[[Histoplasmosis epidemiology and demographics|Epidemiology and Demographics]]==


==Treatment==
==[[Histoplasmosis risk factors|Risk Factors]]==
[[Antifungal]] medications are used to treat severe cases of acute histoplasmosis and all cases of chronic and disseminated disease. Typical treatment of severe disease first involves treatment with [[amphotericin B]], followed by oral [[itraconazole]].<ref>{{cite web |url=http://www.merck.com/mmhe/sec17/ch197/ch197g.html |title=Histoplasmosis: Fungal Infections: Merck Manual Home Edition |format= |work=}}</ref> In many milder cases, simply itraconazole is sufficient. Asymptomatic disease is typically not treated. Past infection results in partial protection against ill effects if reinfected.


==Prevention==
==[[Histoplasmosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
It is not practical to test or decontaminate most sites that may be contaminated with ''H. capsulatum'', but the following precautions can be taken to reduce a person's risk of exposure:


* Avoid areas that may harbor the fungus, e.g., accumulations of bird or bat droppings.
==Diagnosis==
* Before starting a job or activity having a risk for exposure to ''H. capsulatum'', consult the [[NIOSH]]/NCID Document Histoplasmosis: Protecting Workers at Risk. This document contains information on work practices and personal protective equipment that will reduce the risk of infection.
[[Histoplasmosis history and symptoms|History and Symptoms]] | [[Histoplasmosis physical examination|Physical Examination]] | [[Histoplasmosis laboratory findings|Laboratory Findings]] | [[Histoplasmosis chest x ray|Chest X Ray]] | [[Histoplasmosis CT|CT]] | [[Histoplasmosis other imaging findings|Other Imaging Findings]] | [[Histoplasmosis other diagnostic studies|Other Diagnostic Studies]]


==Histoplasmosis in Popular Culture==
==Treatment==
* Johnny Cash included a reference to the disease, even correctly noting its source in bird droppings, in the song "Beans for Breakfast".<ref>[http://www.hotlyrics.net/lyrics/J/Johnny_Cash/Beans_For_Breakfast.html Beans for Breakfast lyrics]</ref>
[[Histoplasmosis medical therapy|Medical Therapy]] | [[Histoplasmosis surgery|Surgery]] | [[Histoplasmosis primary prevention|Primary Prevention]]  | [[Histoplasmosis secondary prevention|Secondary Prevention]]


* Bob Dylan was hospitalized due to histoplasmosis in 1997, causing the cancellation of concerts in the United Kingdom and Switzerland.<ref>[http://www.cnn.com/SHOWBIZ/9705/28/dylan.ill/ CNN - Bob Dylan hospitalized with Histoplasmosis]</ref>


* In the episode Family, episode 21 of season 3 of the television show 'House, M.D.' a patient was diagnosed with histoplasmosis.<ref>House episode "Family"</ref>
{{Mycoses}}


==References==
{{WikiDoc Help Menu}}
<references/>
{{WikiDoc Sources}}
 
''Note: The original version of this article is adapted from the U.S. CDC public domain document at http://www.cdc.gov/ncidod/dbmd/diseaseinfo/histoplasmosis_g.htm ''
 
==External links==
*[http://www.nei.nih.gov/health/histoplasmosis/index.asp Histoplasmosis] Resource Guide from the National Eye Institute (NEI).
*[http://www.cdc.gov/niosh/docs/2005-109/ NIOSH - Histoplasmosis - Protecting Workers at Risk]
*[http://www.fibrosing-mediastinitis.com/ Fibrosing Mediastinitis]
 
{{Mycoses}}


[[Category:Fungal diseases]]
[[Category:Fungal diseases]]
[[Category:Rat carried diseases]]
[[Category:Rat carried diseases]]
[[Category:Overview complete]]
[[Category:Emergency mdicine]]
 
[[Category:Disease]]
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[[es:Histoplasmosis]]
[[Category:Infectious disease]]
[[fr:Histoplasmose]]
[[Category:Pulmonology]]
[[hu:Histoplasmosis]]
[[Category:Gastroenterology]]
[[nl:Histoplasmose]]
[[pl:Histoplazmoza]]
[[pt:Histoplasmose]]
 
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Latest revision as of 22:11, 29 July 2020

Histoplasmosis
Histoplasma capsulatum. Methenamine silver stain showing histopathologic changes in histoplasmosis.

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This page is about clinical aspects of the disease.  For microbiologic aspects of the causative organism(s), see Histoplasma capsulatum.

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Serge Korjian M.D., Vidit Bhargava, M.B.B.S [2], Prince Tano Djan, BSc, MBChB [3], Aravind Kuchkuntla, M.B.B.S[4]

Synonyms and keywords: Ajellomyces capsulatus; Darling's disease; Cave's disease; Ohio valley disease; Spelunker's lung.

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Histoplasmosis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | CT | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention


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