Histoplasmosis - disseminated
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Definition
Disseminated histoplasmosis is a fungal infection that occurs after inhaling the spores of the fungus Histoplasma capsulatum.
See also:
Alternative Names
Systemic histoplasmosis
Causes, incidence, and risk factors
Histoplasmosis is caused by a fungus found in the central and eastern United States (Mississippi and Ohio River Valley), eastern Canada, Mexico, Central America, South America, Africa, and Southeast Asia.
Most cases are mild or without symptoms. Acute pulmonary histoplasmosis may occur in epidemics after heavy exposure. Progressive or spreading (disseminated) and chronic disease can also occur. In disseminated disease, the infection has spread to other organs from the lungs through the bloodstream.
The liver and spleen are usually enlarged, and any body organ may be involved. Ulcerations of the mouth or gastrointestinal tract may occur. Risk factors are travel to or residence within the central or eastern United States, and exposure to the droppings of birds and bats.
References
Kauffman CA. Histoplasmosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 353.
Review Date: 12/1/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Systemic histoplasmosis
Symptoms
- Chills
- Cough
- Fever
- Headache
- Joint pain
- Mental status changes
- Muscle aches and stiffness
- Nausea, vomiting
- Possible rash (erythema nodosum)
- Skin lesions
- Visual changes (chorioretinitis)
Signs and tests
A physical examination may show abnormalities throughout the body.
Tests used to diagnose disseminated histoplasmosis may include:
References
Kauffman CA. Histoplasmosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 353.
Review Date: 12/1/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Systemic histoplasmosis
Treatment
Doctors prescribe antifungal medications to control the infection. Most patients should be treated for a year or more. Those who have suppressed immune systems (for example, from AIDS) may need lifelong treatment.
Expectations (prognosis)
The disease may progress rapidly and death can occur.
Complications
Multiple organs are affected.
Calling your health care provider
Call your health care provider if you develop symptoms of disseminated histoplasmosis, particularly if you have been recently treated for acute or chronic histoplasmosis.
Emergency symptoms include mental status changes and rapid worsening of the condition.
References
Kauffman CA. Histoplasmosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 353.
Review Date: 12/1/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Systemic histoplasmosis
Prevention
Avoiding travel to areas where this spore is found can prevent the disease, but this may not be practical. Avoid bird or bat droppings if you are in one of these areas, especially if you are immunosuppressed.
References
Kauffman CA. Histoplasmosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 353.
Review Date: 12/1/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 12/1/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.