Pulmonary Histoplasmosis Quick Facts on Histoplasma capsulatum: • Dimorphic fungi, in yeast phase within the body • Most common endemic fungal disease • Most common in North America: Central and Midwest US, Ohio and Mississippi river valleys • Lives in soil, especially contaminated with bird or bat droppings Making the Diagnosis of Histoplasmosis: • Histology / cytology, Sputum / BAL cx, Serum and Urine, Antigen testing, Serology, PCR Treatment: • Depends on severity and chronicity of disease • Resistant to echinocandins (e.g. micafungin)!! • Mild to moderate disease: - Treat with azole - Itraconazole first line - Duration depends on acute or chronic disease • Severe disease - Liposomal amphotericin - Followed by extended azole therapy - Add corticosteroids for respiratory failure (guidelines / data vary!) @PulmPEEPs #Pulmonary #Histoplasmosis #capsulatum #diagnosis #management #treatment #Histoplasma
