Treatment:

The main treatment for histoplasmosis is antifungal therapy. In the case of pulmonary histoplasmosis, this may include oral (taken by mouth) medicines such as itraconazole or ketoconazole. In some cases, long-term treatment with anti-fungal drugs may be used after treatment with amphotericin, in patients who are immunosuppressed (for example, people with AIDS).

Expectations (prognosis):

Prognosis depends on the clinical syndrome. Mortality is highest in disseminated histoplasmosis (up to 80% without treatment; decreased to 25% with treatment).

Complications:

• Inflammatory syndromes involving:
  • Heart lining (pericarditis)
  • Joints (arthritis)
  • Skin nodules
  • Rashes (erythema nodosum, erythema multiforme)

• Fibrosing mediastinitis -- scarring in the chest that may entrap structures in the chest cavity:
  • Lymph nodes
  • Heart
  • Great vessels (the major blood vessels carrying blood to and from the heart)
  • Esophagus (food pipe)
• Mediastinal granuloma -- enlarged chest-cavity lymph nodes, which may compress structures such as the esophagus and lung blood vessels

In individuals with weakened immune systems, disseminated disease may occur and involve the meninges (causing meningitis)

Side effects of medications (can be severe with amphotericin) are complications of histoplasmosis.

Calling your health care provider:

Notify your health care provider if you live in an area where histoplasmosis is common, and you develop flu-like symptoms, chest pain, cough and shortness of breath. While there are many other illnesses that have similar symptoms, you may need to be tested for the possibility of histoplasmosis.