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Histoplasmosis: a clinical and laboratory update.
Clin Microbiol Rev. 2007 Jan; 20(1):115-32.CM

Abstract

Infection with Histoplasma capsulatum occurs commonly in areas in the Midwestern United States and Central America, but symptomatic disease requiring medical care is manifest in very few patients. The extent of disease depends on the number of conidia inhaled and the function of the host's cellular immune system. Pulmonary infection is the primary manifestation of histoplasmosis, varying from mild pneumonitis to severe acute respiratory distress syndrome. In those with emphysema, a chronic progressive form of histoplasmosis can ensue. Dissemination of H. capsulatum within macrophages is common and becomes symptomatic primarily in patients with defects in cellular immunity. The spectrum of disseminated infection includes acute, severe, life-threatening sepsis and chronic, slowly progressive infection. Diagnostic accuracy has improved greatly with the use of an assay for Histoplasma antigen in the urine; serology remains useful for certain forms of histoplasmosis, and culture is the ultimate confirming diagnostic test. Classically, histoplasmosis has been treated with long courses of amphotericin B. Today, amphotericin B is rarely used except for severe infection and then only for a few weeks, followed by azole therapy. Itraconazole is the azole of choice following initial amphotericin B treatment and for primary treatment of mild to moderate histoplasmosis.

Authors+Show Affiliations

Infectious Diseases Division, Department of Internal Medicine, Ann Arbor Veterans Affairs Healthcare System, University of Michigan Medical School, Ann Arbor, MI, USA. ckauff@umich.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17223625

Citation

Kauffman, Carol A.. "Histoplasmosis: a Clinical and Laboratory Update." Clinical Microbiology Reviews, vol. 20, no. 1, 2007, pp. 115-32.
Kauffman CA. Histoplasmosis: a clinical and laboratory update. Clin Microbiol Rev. 2007;20(1):115-32.
Kauffman, C. A. (2007). Histoplasmosis: a clinical and laboratory update. Clinical Microbiology Reviews, 20(1), 115-32.
Kauffman CA. Histoplasmosis: a Clinical and Laboratory Update. Clin Microbiol Rev. 2007;20(1):115-32. PubMed PMID: 17223625.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Histoplasmosis: a clinical and laboratory update. A1 - Kauffman,Carol A, PY - 2007/1/16/pubmed PY - 2007/3/28/medline PY - 2007/1/16/entrez SP - 115 EP - 32 JF - Clinical microbiology reviews JO - Clin. Microbiol. Rev. VL - 20 IS - 1 N2 - Infection with Histoplasma capsulatum occurs commonly in areas in the Midwestern United States and Central America, but symptomatic disease requiring medical care is manifest in very few patients. The extent of disease depends on the number of conidia inhaled and the function of the host's cellular immune system. Pulmonary infection is the primary manifestation of histoplasmosis, varying from mild pneumonitis to severe acute respiratory distress syndrome. In those with emphysema, a chronic progressive form of histoplasmosis can ensue. Dissemination of H. capsulatum within macrophages is common and becomes symptomatic primarily in patients with defects in cellular immunity. The spectrum of disseminated infection includes acute, severe, life-threatening sepsis and chronic, slowly progressive infection. Diagnostic accuracy has improved greatly with the use of an assay for Histoplasma antigen in the urine; serology remains useful for certain forms of histoplasmosis, and culture is the ultimate confirming diagnostic test. Classically, histoplasmosis has been treated with long courses of amphotericin B. Today, amphotericin B is rarely used except for severe infection and then only for a few weeks, followed by azole therapy. Itraconazole is the azole of choice following initial amphotericin B treatment and for primary treatment of mild to moderate histoplasmosis. SN - 0893-8512 UR - https://www.unboundmedicine.com/medline/citation/17223625/full_citation L2 - http://cmr.asm.org/cgi/pmidlookup?view=long&pmid=17223625 DB - PRIME DP - Unbound Medicine ER -