Description
- Fungal infection with Histoplasma capsulatum, a dimorphic soil-dwelling saprophyte that has multiple clinical manifestations.
- Initial infection is often asymptomatic.
- Other manifestations include a self-limited flu-like syndrome; mediastinal fibrosis scar tissue; residual, chronic cavitary disease in those with obstructive lung disease; and disseminated histoplasmosis, which is more frequent in the immunocompromised host and infants.
- H. capsulatum:
- Worldwide distribution: Most endemic region in North America is central US
- Exists in mycelial form in nature and in yeast phase when exposed to mammalian temperatures
- Spores may remain active for up to 10 years
- Exposure to bird or bat excrement promotes growth of the fungus for unexplained reasons.
- Chronic pulmonary histoplasmosis: Usually occurs in white males with obstructive lung disease and apical bullous lung pathology. These patients exhibit evidence of an indolent infectious process.
- Disseminated histoplasmosis infection in the immunocompromised is a rare opportunistic infection, which may mimic sepsis syndrome and progress to multiple organ system failure.
- System(s) affected: GI; Hemic/Lymphatic/Immunologic; Pulmonary; Skin/Exocrine
ALERTGeriatric ConsiderationsIncreased incidence of disseminated histoplasmosis in males during 6th and 7th decades
Pediatric Considerations1/3 of cases of disseminated histoplasmosis occur in infants <1 year old.
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