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Histoplasmosis

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Essentials of Clinical Mycology

Abstract

Histoplasmosis, the most common endemic mycosis in the United States, is caused by Histoplasma capsulatum var. capsulatum. Histoplasma capsulatum var. duboisii causes African histoplasmosis, which has different clinical manifestations. Histoplasma capsulatum is a thermally dimorphic fungus; in the environment and at temperatures below 35°C, it exists as a mould, and in tissues and at 35–37°C, as a yeast. In the highly endemic area, along the Mississippi and Ohio River valleys in the United States, most persons are infected in childhood. The primary site of infection is the lungs following inhalation of the conidia from the environment. The severity of disease is related to the number of conidia inhaled and the immune response of the host; the primary host defense mechanism against H. capsulatum is cell-mediated immunity. Pulmonary infection is asymptomatic or only mildly symptomatic in most persons who have been infected; acute severe pneumonia and chronic progressive pulmonary infection also can occur. Asymptomatic dissemination of H. capsulatum to the organs of the reticuloendothelial system occurs in most infected individuals; however, symptomatic acute or chronic disseminated histoplasmosis, which is a life-threatening infection, occurs almost entirely in persons who have deficient cell-mediated immunity. Antifungal therapy is highly effective. For patients with mild-to-moderate histoplasmosis, itraconazole is the treatment of choice; for patients with severe infection, amphotericin B is required.

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  1. Division of Infectious Diseases, University of Michigan Medical School, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA

    Carol A. Kauffman

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  1. Carol A. Kauffman
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Correspondence to Carol A. Kauffman .

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Editors and Affiliations

  1. Veterans Affairs Ann Arbor Healthcare, Professor of Internal Medicine, University of Michigan Medical School, 2215 Fuller Road, Ann Arbor, 48105, Michigan, USA

    Carol A. Kauffman

  2. Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Blvd., Birmingham, 35294, Alabama, USA

    Peter G. Pappas

  3. Division of Infectious Diseases, Wayne State University School of Medicin, 3990 John R Street, Detroit, 48201, Michigan, USA

    Jack D. Sobel

  4. School of Medicine, Professor Emeritus of Medicine, University of Alabama at Birmingham, 1530 3rd Avenue South, Birmingham, 35294, Alabama, USA

    William E. Dismukes

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Kauffman, C.A. (2011). Histoplasmosis. In: Kauffman, C., Pappas, P., Sobel, J., Dismukes, W. (eds) Essentials of Clinical Mycology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6640-7_18

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