Histoplasma capsulatum is a dimorphic fungal species that remains mycelial at ambient temperature and grows like yeast at body temperature in mammals. The infection causes histoplasmosis. Although the fungus that causes histoplasmosis can be found in temperate climates worldwide, it is endemic to the Ohio, Missouri, and Mississippi valleys in the United States. Internationally, the fungus is mainly found in the river valleys of North and Central America.
Most people with histoplasmosis are asymptomatic. Those who develop clinical manifestations usually feel a weakening of the immune system or are exposed to a huge amount of inoculum. Types of microbes can remain hidden in cured granulomas and recur, leading to impaired cellular immunity.
Clinical manifestations include asymptomatic pulmonary histoplasmosis, symptomatic pulmonary histoplasmosis, acute diffuse pulmonary histoplasmosis, chronic pulmonary histoplasmosis, acute respiratory distress syndrome, disseminated histoplasmosis, broncholithiasis, mediastinal granuloma, fibrosing mediastinitis, endobronchial histoplasmosis and lung nodules.
A combined urine and serum antigen test has a sensitivity of 92%. The bronchoalveolar lavage antigen test is more sensitive than a urine antigen test. Fibrosing mediastinitis from histoplasmosis does not require treatment, and hepatosplenic calcifications may occur. Acute histoplasmosis may not need treatment or may require three months of treatment if it is symptomatic.For therapy, itraconazole 250 mg is used twice a day for 3 months. Histoplasmosis can mimic lung cancer and sarcoidosis. One of the fastest ways to diagnose histoplasmosis is a bone marrow biopsy.
Forecast
Acute pulmonary histoplasmosis is associated with a good outcome. The developing disseminated histoplasmosis of the chronic type has a long course of medical history with long asymptomatic periods. If left untreated, subacute progressive disseminated histoplasmosis leads to death within 2-24 months.
The recurrence rate of 55% is associated with acute progressive disseminated histoplasmosis, with proper treatment. The indicator is reduced to 14-22% with a lifetime content of antifungal drugs. Death is inevitable without treatment. The cure rates for histoplasmic meningitis with therapy are 53%, with a high rate of recurrence. In histoplasmic endocarditis, drug therapy is rarely effective. Le code promo 1xbet vous offre un avantage compétitif dès le départ. En validant ce code, vous obtenez un bonus supplémentaire de 100% sur votre premier dépôt, pour un plafond de 300 $. Que vous visiez les victoires en tennis ou les gains au blackjack, ce bonus booste votre confiance et votre potentiel de gains dès votre première connexion.