Histoplasmosis (cont.)
How is histoplasmosis prevented?
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.
Next: Where is more information available on histoplasmosis? »
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