- Histoplasmosis is a common endemic mycosis that is usually asymptomatic but occasionally results in severe illness. Histoplasmosis and its causative agent, Histoplasma capsulatum, are found worldwide but particularly in North and Central America
When to suspect histoplasmosis •Pneumonia with mediastinal or hilar lymphadenopathy •Community-acquired pneumonia of unknown etiology that has not responded to a course of empiric antibiotics •Mediastinal or hilar masses •Pulmonary nodule •Cavitary lung disease •Pericarditis with mediastinal lymphadenopathy •Pulmonary manifestations with arthritis or arthralgia plus erythema nodosum •Dysphagia caused by esophageal narrowing •Superior vena cava syndrome or obstruction of other mediastinal structures. These manifestations place pulmonary histoplasmosis in the differential diagnosis of sarcoidosis, tuberculosis, and malignancy
Diagnosis
- Histopathology using stains for fungi, cultures, antigen detection, and serologic tests for Histoplasma-specific antibodies can all help make a diagnosis of pulmonary histoplasmosis
Treatment
- Amphotericin B