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Area of Science:

  • Mycology
  • Infectious Diseases
  • Immunology

Background:

  • Histoplasmosis is an endemic mycosis caused by Histoplasma capsulatum, often acquired through inhalation.
  • Disseminated disease is common in individuals with impaired cellular immunity.
  • Clinical symptoms include fever, fatigue, weight loss, and respiratory issues.

Purpose of the Study:

  • To review the pathogenesis, clinical manifestations, diagnosis, and treatment of histoplasmosis.
  • To highlight the diagnostic utility of Histoplasma antigen detection.
  • To outline current treatment guidelines and potential complications.

Main Methods:

  • Review of personal experience and relevant publications.
  • Discussion of diagnostic methods including antigen detection, culture, pathology, and antibody detection.
  • Analysis of treatment protocols and management of complications.

Main Results:

  • Histoplasma antigen detection demonstrates high sensitivity (95-100% in urine, >90% in serum/BAL, 78% in CSF).
  • Culture and pathology offer 70-80% sensitivity, while antibody detection ranges from 60-70%.
  • Recommended treatment involves liposomal amphotericin B followed by itraconazole for at least one year, with careful monitoring.

Conclusions:

  • Histoplasma antigen detection is the most sensitive diagnostic method.
  • Prolonged antifungal therapy with itraconazole is crucial for patients with impaired immunity.
  • Monitoring for treatment effectiveness, relapse, and immune reconstitution inflammatory syndrome is essential.