Presentation
Chronic cavitary pulmonary histoplasmosis is one of the rarest clinical presentations of this disease. The differential diagnosis with tuberculosis should be made in patients presenting with cavitated lesions in upper lung segments. [ncbi.nlm.nih.gov]
Immune System
- Splenomegaly
Many dogs have a protracted course of weight loss to emaciation, chronic cough, persistent diarrhea, fever, anemia, hepatomegaly, splenomegaly, lymphadenopathy, and nasopharyngeal and GI ulceration. [merckvetmanual.com]
[…] self-limited in immunocompetent patients, but disseminates in immunocompromised (very young, very old, HIV+) to liver, spleen, bone marrow, nodes, lung, rarely to skin Disseminated disease: strongly associated with AIDS; patients have fever, weight loss, splenomegaly [pathologyoutlines.com]
[…] pulmonary fibrocavitary disease resembling tuberculosis; in immunosuppressed patients, and rarely, in otherwise healthy persons, histoplasmosis may cause disseminated disease of the reticuloendothelial system, which is manifested by fever, emaciation, splenomegaly [medical-dictionary.thefreedictionary.com]
A wide spread of features may be found - fever, lymphadenopathy, hepatomegaly, splenomegaly, jaundice, leukopenia, chronic meningitis, endocarditis, granulomatous hepatitis, Addison’s disease and GIT ulceration. [ayubmed.edu.pk]
[…] consistency of the lungs Disseminated Form: Regional or generalized lymphadenopathy: Affected lymph nodes are firm and uniform in appearance, resembling lymphoma Intestines: Nodular thickening of mucosal surface, resembling Johne’s disease of cattle Splenomegaly [askjpc.org]
Entire Body System
- Fever
Soon after, he developed fever with pulmonary nodules. Fine-needle aspiration from lung nodules showed intracellular yeast forms of histoplasma. The patient responded well to amphotericin B with subsidence of fever. [ncbi.nlm.nih.gov]
Fevers may occur in anyone at any age; however, this article is specifically addressing fever in adults. Every one of us has experienced the wave of chills and exhaustion that a fever causes. [emedicinehealth.com]
B38.0- B38.2 ) pneumonia in cytomegalovirus disease ( B25.0 ) pneumonia in toxoplasmosis ( B58.3 ) rubella pneumonia ( B06.81 ) salmonella pneumonia ( A02.22 ) spirochetal infection NEC with pneumonia ( A69.8 ) tularemia pneumonia ( A21.2 ) typhoid fever [icd10data.com]
The most common signs in any infection of Histoplasma capsulatum are fever, tiredness, and lack of appetite. [wagwalking.com]
- Weight Loss
Clinical signs may be nonspecific but often include respiratory difficulty, fever, depression, anorexia, and weight loss. [merckvetmanual.com]
CASE REPORT A 60-year-old man, resident of Battagram, with long standing diabetes mellitus type II presented with left sided chest pain, weight loss and a left sided pleural effusion in July 1999. [ayubmed.edu.pk]
The patient visited our hospital with dyspnea, blood-tinged sputum, and weight loss, which had appeared 2 months earlier. The patient underwent video-assisted thoracic surgery (VATS) lung biopsy. [ncbi.nlm.nih.gov]
When to Call Your Health Care Provider Call your health care provider right away if you have any of the following: Fever Chest pain Coughing up blood Shortness of breath Extreme tiredness Loss of appetite and weight loss Symptoms that don’t get better [sterlingcare.com]
- Malaise
[…] interrogated in the history should include travel to endemic areas as well as exposures significant populations of bats and birds. acute pulmonary histoplasmosis 90% of cases can have no symptoms symptoms manifest for up to two weeks after exposure fever, malaise [radiopaedia.org]
Acute primary histoplasmosis is a syndrome with fever, cough, myalgias, chest pain, and malaise of varying severity. Acute pneumonia (evident on physical examination and chest x-ray) sometimes develops. [merckmanuals.com]
[…] pain, cough and other respiratory symptoms Skin lesions and joint pain occur in 5-6% of patients, mainly female Chronic pulmonary histoplasmosis Occurs mostly in patients with underlying lung disease Symptoms include coughing up blood, weight loss, malaise [dermnetnz.org]
Malaise, fatigability, low-grade fever, aching chest pain and mild cough lasting a few days to a few weeks are usual. Symptoms are ameliorated by rest. Rest and diminished activity are recommended as treatment. [ncbi.nlm.nih.gov]
[…] include fever, headache, nonproductive cough, chills, pleuritic chest pain, weight loss, malaise, myalgias, and sweats. [aafp.org]
- Pseudotumor
To our knowledge, this is the first case of a spindle cell "pseudotumor" of the lung resulting from histoplasmosis. [ncbi.nlm.nih.gov]
- Intermittent Fever
Case Presentation A 60-year-old female patient presented to the medical outpatient department with a history of a cough for more than two months, intermittent fever, and dyspnea on exertion. [cureus.com]
Respiratoric
- Cough
A 21-year-old previously healthy woman presented with a three-week history of shortness of breath and dry cough. She had recently returned from a humanitarian trip planting crops in El Salvador. [ncbi.nlm.nih.gov]
His dry cough had been persistent for the last 4 years, but a history of productive mucopurulent sputum had been present for almost 8 months. [ayubmed.edu.pk]
If symptoms do occur, they may include: fever, chills, dry cough, and chest pain. Some people also have joint pain. [sterlingcare.com]
- Pleural Effusion
Ultrasound chest confirmed it to be a loculated pleural effusion. A pleural biopsy was arranged but it was not informative at all and the loculated pleural effusion could not be drained with the Abram’s needle. [ayubmed.edu.pk]
Infection with H capsulatum was confirmed by culture of pleural effusion fluid, DNA probe analysis of the pleural fluid culture isolate, urinary Histoplasma antigen detection, and Grocott methenamine silver stains of tissue sections. [ncbi.nlm.nih.gov]
effusions are possible but uncommon healing process with formation of histoplasmomas, which are well-defined nodules with central calcifications Promoted articles (advertising) [radiopaedia.org]
Few may get acute pericarditis and pleural effusions. As the severity of the disease increases, the prognosis worsens from fair to poor. [emedicinehealth.com]
Clinical manifestations depend on the immune status of the infected person and may present as acute pulmonary histoplasmosis, chronic cavitary pulmonary histoplasmosis, granulomatous mediastinitis, mediastinal fibrosis, pericarditis, pleural effusion, [cureus.com]
- Productive Cough
Some infections may cause acute pulmonary histoplasmosis, characterized by high fever, headache, non-productive cough, chills, weakness, pleuritic chest pain and fatigue. [who.int]
As in our patient, the symptoms of malaise, productive cough, fever, and night sweats in pulmonary histoplasmosis are similar to those of TB but are usually less severe [ 4 ]. [jmedicalcasereports.biomedcentral.com]
His dry cough had been persistent for the last 4 years, but a history of productive mucopurulent sputum had been present for almost 8 months. [ayubmed.edu.pk]
The presentation is similar to chronic pulmonary aspergillosis with productive cough, increasing shortness of breath, weight loss, night sweats and sometimes fever. [life-worldwide.org]
The signs and symptoms associated with Acute Pulmonary Histoplasmosis (in those having weak immunity) may include: Chest tightness Breathing difficulties Productive cough Fever Muscle pain, generalized body aches Skin rashes that usually occur on the [dovemed.com]
- Hemoptysis
[…] bats and birds. acute pulmonary histoplasmosis 90% of cases can have no symptoms symptoms manifest for up to two weeks after exposure fever, malaise, headache, myalgia, abdominal pain dyspnea can manifest if there is diffuse involvement a cough and hemoptysis [radiopaedia.org]
Smokers with structural lung disease have higher probability of developing chronic cavitary histoplasmosis. [ citation needed ] After healing of lesions, hard calcified lymph nodes can erode the walls of airway causing hemoptysis. [ citation needed ] [en.wikipedia.org]
Recurrent hemoptysis is a common symptom and respiratory failure often ensues. [antimicrobe.org]
[…] nodules. 1 Mediastinal granuloma, pericarditis, and rheumatologic syndromes (i.e., arthritis) are possible sequelae following acute infections of pulmonary histoplasmosis ( Table 1 ). 4, 5 Actively inflamed mediastinal lymph nodes cause chest pain, cough, hemoptysis [aafp.org]
- Chronic Cough
Once established, an infected cavity tends to persist and to be attended by symptoms of chronic bronchitis with chronic cough and sputum, fatigability, anorexia, and weight loss. [ncbi.nlm.nih.gov]
Many dogs have a protracted course of weight loss to emaciation, chronic cough, persistent diarrhea, fever, anemia, hepatomegaly, splenomegaly, lymphadenopathy, and nasopharyngeal and GI ulceration. [merckvetmanual.com]
A high ESR (62mm / 1 st hour), with three consecutive negative sputum samples for Acid Fast Bacilli (AFB) and a clinical history of night sweats, weight loss and chronic cough with deteriorating health had convinced us to commence anti-tuberculous therapy [ayubmed.edu.pk]
Cardiovascular
- Chest Pain
Histoplasmosis Symptoms Chest Pain There are many causes of chest pain. A serious form of chest pain is angina, which is a symptom of heart disease and results from inadequate oxygen supply to the heart muscle. [medicinenet.com]
They gave a history of fever, fatigue, myalgia, dry cough, and chest pain during the stay or just after returning from Ecuador. In two patients, symptoms persisted in mild nature. [ncbi.nlm.nih.gov]
Often, the diagnosis is first suggested by a chest X-ray done for another purpose. If symptoms do occur, they may include: fever, chills, dry cough, and chest pain. Some people also have joint pain. [sterlingcare.com]
This case has certain resemblance with the presentation of multiple loculi and a large pleural effusion with chest pain, fever and chills of a patient with histoplasmosis reported by Richardson JV in a chest journal in 1997 10. [ayubmed.edu.pk]
Neurologic
- Excitement
Exploring caves is, without doubt, a very exciting adventure; however, it carries some dangers. Three of four travellers were admitted to hospital with lung changes after returning from Ecuador, successively. [ncbi.nlm.nih.gov]
- Involuntary Movements
She also developed new symptoms such as jerking involuntary movements in upper limbs, head ache and fatigue. She also reported falling school grades and visual disturbances. [mycology.imedpub.com]
Workup
The workup for suspected histoplasmosis should include test for antibodies and antigens. [mycology.imedpub.com]
X-Ray
- Bilateral Pulmonary Opacities
A 44-year-old man presented to the emergency department with progressive pulmonary symptoms. He was hypoxic with bilateral pulmonary opacities on chest radiograph. CT of the chest showed a geographical pattern of ground-glass attenuation. [ncbi.nlm.nih.gov]
- Bilateral Hilar Adenopathy
Night sweats, weight loss and productive cough with chest radiology showing uni- or bilateral hilar adenopathy with fibronodular shadows in the upper zones of the lungs are the hallmark features. 33 percent of the cases improve spontaneously but the rest [ayubmed.edu.pk]
Serum
- Hypocapnia
There is also hypocapnia from alveolar hyperventilation commonly found in restrictive and stiff lung syndrome. [ncbi.nlm.nih.gov]
Pleura
- Pleural Effusion
Ultrasound chest confirmed it to be a loculated pleural effusion. A pleural biopsy was arranged but it was not informative at all and the loculated pleural effusion could not be drained with the Abram’s needle. [ayubmed.edu.pk]
Infection with H capsulatum was confirmed by culture of pleural effusion fluid, DNA probe analysis of the pleural fluid culture isolate, urinary Histoplasma antigen detection, and Grocott methenamine silver stains of tissue sections. [ncbi.nlm.nih.gov]
effusions are possible but uncommon healing process with formation of histoplasmomas, which are well-defined nodules with central calcifications Promoted articles (advertising) [radiopaedia.org]
Few may get acute pericarditis and pleural effusions. As the severity of the disease increases, the prognosis worsens from fair to poor. [emedicinehealth.com]
Clinical manifestations depend on the immune status of the infected person and may present as acute pulmonary histoplasmosis, chronic cavitary pulmonary histoplasmosis, granulomatous mediastinitis, mediastinal fibrosis, pericarditis, pleural effusion, [cureus.com]
Treatment
However, relapses occurred within a period of 1 to 18 months after the interruption of the treatment. Mycological diagnosis and the difficulties observed in the treatment were discussed. [ncbi.nlm.nih.gov]
What is the treatment for histoplasmosis? Mild cases of histoplasmosis that are limited to the lungs will resolve without specific treatment in about a month. [medicinenet.com]
Prognosis
What is the prognosis of histoplasmosis? People with mild symptoms of histoplasmosis usually resolve the disease on their own without treatment. In more severe cases, the prognosis is good for those who receive appropriate treatment. [medicinenet.com]
If this occurs, the prognosis is less favorable. [ufhealth.org]
Prognosis Most people recover from primary histoplasmosis in a few weeks without medical intervention. [medical-dictionary.thefreedictionary.com]
However, those with poor immune systems need to be watched closely for disseminated infection or severe forms of the infection, which can be fatal, if not treated properly The prognosis of Acute Pulmonary Histoplasmosis is excellent with appropriate treatment [dovemed.com]
Etiology
Histoplasmosis, a dimorphic fungus, and sarcoidosis, a disease of unknown etiology, share many clinical features, including typical manifestations of granulomatous inflammation involving the lungs and mediastinal lymphatics in association with constitutional [ncbi.nlm.nih.gov]
MORPHOLOGIC DIAGNOSIS: Lung: Pneumonia, granulomatous, diffuse, marked, with numerous intrahistiocytic and extracellular yeast, etiology consistent with Histoplasma capsulatum var. capsulatum, Thoroughbred, equine. [askjpc.org]
[…] and Discontinuation 339 Oxygen Therapy and Toxicity 345 ProtocolDriven Care in Respiratory Therapy 351 Epidemiology Natural History 357 Prophylaxis 364 Chronic Thromboembolic Pulmonary Hypertension 375 Unusual Forms of Embolism 384 Pathogenesis and Etiology [books.google.de]
Histoplasmosis Characteristics • Member of the phylum Ascomycota • Worldwide distribution • Naturally found in fecal-contaminated soils • Birds and bats appear to be reservoirs • Etiologic agent of histoplasmosis 4. [slideshare.net]
Histoplasmosis by Jennifer Kang Histoplasmosis (Ohio River Valley Fever, Darling's disease); Etiological agent- Histoplasma capsulatum (1). Transmission : Histoplasmosis is a noncommunicable disease. [austincc.edu]
Epidemiology
Final diagnosis was made on epidemiological histories, as well as typical radiological changes, and was supported by positive tests for antibodies to Histoplasma capsulatum. [ncbi.nlm.nih.gov]
Pathophysiology
[…] profound, can calcify Extrapulmonary findings: Liver and spleen calcifications, adrenals, oral ulcers, bone marrow Differentials: Sarcoidosis and tuberculosis Usual treatment: Itraconazole; amphotericin for severe or diffuse disease Prognosis: Excellent Pathophysiology [emedicine.medscape.com]
Prospective study of histoplasmosis in patients infected with human immunodeficiency virus: incidence, risk factors, and pathophysiology. Clin Infect Dis 1997; 24:1195-203. 10. Wheat J. Histoplasmosis in the acquired immunodeficiency syndrome. [hivinsite.ucsf.edu]
Prevention
Fungemia may be prevented or arrested by an intact immune system or by other factors not yet known. [ncbi.nlm.nih.gov]
Prevention It's difficult to prevent exposure to the fungus that causes histoplasmosis, especially in areas where the disease is widespread. Even so, these steps may help reduce the risk of infection: Avoid exposure. [mayoclinic.org]