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How I Treat Histoplasmosis

  • Current Management of Fungal Infections (Luis Ostrosky-Zeichner, Section Editor)
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Abstract

Histoplasmosis is an endemic mycosis caused by the dimorphic fungus Histoplasma capsulatum. Some important manifestations of infection include acute or chronic pulmonary disease, histoplasmomas, progressive disseminated histoplasmosis, and central nervous system infection. Depending on the clinical presentation, site of infection and severity of disease, either amphotericin B preparations followed by itraconazole, or itraconazole alone have become the preferred treatments. Because prolonged therapy (6 weeks to 24 months) may be required, careful monitoring for nephrotoxicity in patients on amphotericin B preparations is necessary. In addition, in patients receiving itraconazole, vigilance for drug interactions and pharmacokinetic properties is warranted. Histoplasma antigen testing has improved rapidity of diagnosis and the ability of long-term monitoring for clinical response in patients with histoplasmosis.

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Disclosure

R. M. La Hoz: none; J.E. Loyd: none; L. J. Wheat: Director of MiraVista Diagnostics; J. W. Baddley: Consulting for Pfizer, Merck and Mayne Pharma Group.

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Authors and Affiliations

  1. Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, 229 Tinsley Harrison Tower, Birmingham, AL, 35294-0006, USA

    Ricardo M. La Hoz & John W. Baddley

  2. Vanderbilt University Medical Center, Nashville, TN, USA

    James E. Loyd

  3. MiraVista Diagnostics and MiraBella Technologies, Indianapolis, IN, USA

    L. Joseph Wheat

  4. Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA

    John W. Baddley

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  1. Ricardo M. La Hoz
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  2. James E. Loyd
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Correspondence to John W. Baddley.

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La Hoz, R.M., Loyd, J.E., Wheat, L.J. et al. How I Treat Histoplasmosis. Curr Fungal Infect Rep 7, 36–43 (2013). https://doi.org/10.1007/s12281-012-0117-7

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