Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
People living in endemic areas like the Ohio River Valley are likely to be
exposed to histoplasmosis no matter what they do, since the fungus is likely in
the dust in the air. However, if they are healthy, most people that get exposed
or infected with H. capsulatum will be asymptomatic. Immunosuppressed (those
with HIV or cancer or who are receiving chemotherapy for cancer) might reduce
their chances of exposure if they live in endemic areas by avoiding high dust
areas like construction sites. Soil can be decontaminated with 3% formalin under
special circumstances. If people need to work in potential high exposure areas
like caves, bridges, construction sites, chicken coops, or other areas where
bird and bat droppings could be concentrated, the National Institute for
Occupational Safety and Health (NIOSH) recommends using a Part 84 particulate
respirator certified by NIOSH. Some investigators suggest that simply watering
down soil will help prevent dust formation and reduce the chance of exposure.
There is no vaccine for histoplasmosis. In some cases, H. capsulatum becomes
dormant and may reactivate if the person becomes stressed or immunodepressed.
Although people develop an immune response to histoplasmosis and recover with no
complications, the response is not completely protective and the person can
become reinfected with H. capsulatum.
What is the prognosis (outlook) for people with histoplasmosis?
About 90% of patients who acquire acute pulmonary histoplasmosis are
asymptomatic, and about another 5%-7% who develop symptoms recover completely.
Few may get acute pericarditis and pleural effusions. As the severity of the
disease increases, the chance that lifelong problems may occur also increases.
Patients with chronic pulmonary histoplasmosis usually develop (90%) cavities in
the lungs that may reduce lung capacity and result in respiratory problems and
increase the chances for a secondary lung infection. Progressive disseminated
histoplasmosis has a grim prognosis (death in a few weeks to months) if
appropriate treatment is not received. Even with appropriate treatment, some
patients will experience relapses and may require antifungal medication for the
rest of their life.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
AIDS is the advanced stage of HIV infection. Symptoms and signs of AIDS include pneumonia due to Pneumocystis jiroveci, tuberculosis, toxoplasmosis, seizures, weakness, meningitis, yeast infection of the esophagus, and Kaposi's sarcoma. Anti-retroviral therapy (HAART) is used in the treatment of AIDS.
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