Histoplasmosis (Ohio valley fever) is an infection caused by a fungus. The lung infection is usually mild, but it can be more severe in people with weak immune systems. Such people include those with HIV infection or cancer and those taking immunosuppressive drugs or steroids. Infections can sometimes spread to other parts of the body, including lymph glands, nervous system, and heart. Infants, very young children, and elderly people also have higher risk of severe infection.
The cause is the fungus Histoplasma capsulatum. It’s found in soil, especially that with bird or bat droppings. Breathing air containing the fungus gets it into the lungs. Histoplasmosis isn’t contagious.
Most people have few symptoms such as dry cough or low-grade fever. They may not know that they had histoplasmosis until years later. Symptoms are usually mild and flu-like. They include fever, chills, headache, and muscle aches. More severe symptoms from worse infections may last several weeks. Older people with lung disease (such as smokers with emphysema) can get a chronic infection. Symptoms include coughing up sputum, chest pain, weight loss, night sweats, and fatigue. People with weak immune systems may have widespread infections with severe and longer lasting symptoms of fever, headache, and weight loss.
The health care provider makes a preliminary diagnosis from the medical history and physical examination, especially of the lungs and heart. Chest X-rays and tests of blood, urine, and sputum may also be done.
Mild infections in generally healthy people may go away without treatment. In most people, treatment with antifungal medicine is needed. This medicine can be given by mouth (orally) or intravenously. The intravenous amphotericin-B may be given for up to 3 weeks.
Antifungal medicine may be needed for a long time, often 1 year or more. People with weak immune systems may need lifelong treatment.
Antifungal medicines should always be finished. Stopping too soon may let the disease come back. Blood tests will make sure that the infection is gone.
A healthy lifestyle with regular exercise and good diet helps the body fight the infection. Smokers should stop smoking. Prevent more infections by avoiding places where contaminated dust can be breathed in. These include chicken houses, old buildings, and caves. Workers in dirty or dusty areas should wear facemasks and protective clothing.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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