Histoplasmosis (fungal infection)

Description A fungal infection ...

Description

A fungal infection caused by the Histoplasma capsulatum fungus. The fungus infects people throughout the world. In the U.S., the fungus is most common in the southeastern, mid-Atlantic, and central states. The fungus grows as mold in the soil and enters the body through the lungs when people breath in infected particles. There are three types of infection, an acute lung infection, a chronic lung infection, and an infection that involves the entire body (disseminated). The initial infection can cause symptoms such as cough and fever but some people will not experience any symptoms (asymptomatic). The disseminated infection is more common in the very young, the very old, and in those with a weakened immune system. The disseminated infection is frequently lethal. Long term scarring in the chest can occur resulting in damage to the lungs, blood vessels, esophagus, and heart.

Symptoms

Some people have no symptoms. The acute infection resembles the flu with fever, chills, cough, and chest pain with breathing. The chronic infection causes chest pain, cough, sweating, fever, breathing problems (shortness of breath), and occasionally coughing up blood (hemoptysis). Disseminated infections cause fevers, breathing problems, headaches, confusion, skin nodules, mouth sores, neck stiffness, and joint pain.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. The fungus may be grown from any body fluid. An antigen test can also be done on the blood, urine or cerebrospinal fluid (CSF). X-rays and possibly a CT scan may be performed to see the infection and damage in the chest.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Urinalysis (UA), X-ray

Other Specific Tests: Lumbar puncture, blood culture, sputum culture, urine culture, antigen tests

Specialists:
Infectious Disease Medicine, Pediatric Infectious Disease Medicine

Treatment

Antifungal medications are the main treatment and can be given by mouth or intravenously depending on the seriousness of the infection. The medications used include: itraconazole, ketoconazole and amphotericin. Other treatments may be needed if there is a severe lung infection or a disseminated infection such as admission to the hospital or breathing support.