HISTOPLASMOSIS

Histoplasmosis is caused by a dimorphic fungus and is manifest by epid emics of infection or endemic infection with a spectrum from subclinic al illness to progressive disseminated disease, Diagnosis is best made by visualization of the yeast in tissue or by culture, although detec tion of the fungal antigen in urine specimens is very useful as well, Histoplasma capsulatum. with a heavy inoculum, may cause acute pulmona ry infection in the normal host, resulting in fever, hypoxia, and pulm onary infiltrates, Opportunistic histoplasmosis appears as chronic pul monary histoplasmosis in those with a structural defect in the lung (e mphysema) and as disseminated histoplasmosis in patients with cellular immune deficiency (immunosuppressants, BIDS). Itraconazole is the dru g of choice for both, except in life-threatening infection when amphot ericin B is indicated.