Histoplasmosis Facts (cont.)

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How do physicians diagnose histoplasmosis?

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The symptoms and signs of histoplasmosis are not specific enough to establish the diagnosis. The diagnosis rests upon demonstrating the fungus or an immune response to the fungus. Some of the many diagnostic laboratory tests available include the following:

  • Cultures of body fluids or tissues to identify the fungus
  • Detection of surface markers of Histoplasma in a urine test
  • Blood tests to measure antibody response to Histoplasma
  • Microscopic examination of samples of infected tissues

Chest X-rays in people with acute histoplasmosis are usually normal. However, so-called coin lesions or histoplasmomas may be seen in the chest X-ray of people with healed histoplasmosis. These are round accumulations of scar tissue. Calcification of lymph nodes around the bronchi may be evidence of prior healed infections. Depending on the severity and stage of the disease, infiltrates or other changes may be apparent on X-rays.

CT scans are useful to identify areas of spread in disseminated histoplasmosis.

What is the treatment for histoplasmosis?

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Mild cases of histoplasmosis that are limited to the lungs will resolve without specific treatment in about a month. Severe or disseminated cases of histoplasmosis require treatment with antifungal medications. Itraconazole (Sporanox, Onmel), fluconazole (Diflucan), and amphotericin B (Ambisome, Amphotec; drug of choice for severe disease) are antifungal drugs that are typically used to treat histoplasmosis. Treatment may need to be continued for a period of several months.

Medically Reviewed by a Doctor on 6/3/2014

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