Chronic cavitary histoplasmosis
Chronic pulmonary histoplasmosis is a long-term respiratory infection caused by breathing the spores of the fungus, Histoplasma capsulatum.
Histoplasma capsulatum is a fungus found in the soil of the central and eastern United States (especially Mississippi and Ohio river valleys), eastern Canada, Mexico, Central America, and South America.
The infection occurs when a person breathes in the reproducing parts of the fungus, called spores. Those who have a healthy immune system usually do not have symptoms, or only mild ones.
This "acute" infection does not last, but can leave a person with small scars (granulomas). These scars can be difficult to distinguish from tumors in the lung.
However, the infection can cause severe illness right away, or redevelop years after the first exposure, if a person's immune system is weakened by:
Risk factors for chronic pulmonary histoplasmosis include:
Tests that may be used to diagnose chronic pulmonary histoplasmosis include:
The doctor will prescribe antifungal medications to control the infection within the lung. These medications must be taken for 1 to 2 years.
The infection usually goes away with antifungal medication, but scarring inside the lung often remains. Histoplasmosis is unusual enough that if you develop it, your health care provider should check to find out whether another disease is weakening your immune system.
Often, those who have had chronic pulmonary histoplasmosis must follow up with their doctor, who will check for signs of relapse.
In rare cases, a pulmonary histoplasmosis infection can spread through the blood to other organs. This is called disseminated histoplasmosis. People who have a suppressed immune system and very young children are more likely to develop this condition. If this occurs, the prognosis is less favorable.
Patients who breathe in a large amount of fungus can develop a severe and potentially deadly and sudden type of lung infection.
Call for an appointment with your health care provider if you develop symptoms of chronic pulmonary histoplasmosis.
Call your health care provider if your symptoms continue despite treatment, or if you have breathing difficulty or symptoms of disseminated histoplasmosis.
Be aware of your surroundings, especially if you are in a weakened state from another medical condition, or from immune-suppressing medications.
Kauffman CA. Histoplasmosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 353.
What LJ, Freifeld AG, Kleiman MB, Baddley JW, McKinsey DS, Loyd JE, Kauffman CA. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis, 2007;45(7):807-825.
© 2011 University of Maryland Medical Center (UMMC). All rights reserved.
UMMC is a member of the University of Maryland Medical System,
22 S. Greene Street, Baltimore, MD 21201. TDD: 1-800-735-2258 or 1.866.408.6885