Histoplasma capsulatum - Revision history

Aidan at 15:05, 29 October 2020

2020-10-29T15:05:37Z

← Older revision		Revision as of 15:05, 29 October 2020
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	**Microconidia can be transported for miles by air currents		**Microconidia can be transported for miles by air currents

	=== Risk Factors ===		===Risk Factors===

	* HIV, solid organ transplant, hematologic transplant		*HIV, solid organ transplant, hematologic transplant
	* Primary immunodeficiencies: X-linked hypogammaglobulinemia		*Primary immunodeficiencies: X-linked hypogammaglobulinemia

	===Pathophysiology===		===Pathophysiology===
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	**Antigen of '''urine''' (best), BAL fluid, and serum if available		**Antigen of '''urine''' (best), BAL fluid, and serum if available
	***Urine is best, but only 40% sensitive in cavitary, up to 95% in AIDS patients		***Urine is best, but only 40% sensitive in cavitary, up to 95% in AIDS patients
			****However, this may no longer be the case, with overall sensitivity of 80% and specificity of 90% regardless of sample source
	***Cross-reacts with other endemic fungi; false-positives with antithymocyte globulin		***Cross-reacts with other endemic fungi; false-positives with antithymocyte globulin
	*PCR is possible		*PCR is possible
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	*Should be suspected with any white mold		*Should be suspected with any white mold

	=== Prophylaxis ===		===Prophylaxis===

	* May be indicated for endemic areas in patients with advanced HIV and low CD4 count		*May be indicated for endemic areas in patients with advanced HIV and low CD4 count
	{{DISPLAYTITLE:''Histoplasma capsulatum''}}		{{DISPLAYTITLE:''Histoplasma capsulatum''}}
	[[Category:Dimorphic fungi]]		[[Category:Dimorphic fungi]]

Aidan: /* Prevention */

2020-09-10T14:19:43Z

Prevention

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Aidan at 13:08, 10 September 2020

2020-09-10T13:08:00Z

← Older revision		Revision as of 13:08, 10 September 2020
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	***Small, 2 to 5 μm		***Small, 2 to 5 μm
	***Demonstrates multipolar narrow-based budding		***Demonstrates multipolar narrow-based budding
			***Does not look particularly different from other yeast, but may be intracellular
	*Three variants		*Three variants
	**''H. capsulatum'' var. ''capsulatum'', which is the most common worldwide, and is further divided into various clades		**''H. capsulatum'' var. ''capsulatum'', which is the most common worldwide, and is further divided into various clades

Aidan at 13:06, 10 September 2020

2020-09-10T13:06:44Z

← Older revision		Revision as of 13:06, 10 September 2020
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	**Mold		**Mold
	***Mold form is highly infectious, associated with lab-related outbreaks		***Mold form is highly infectious, associated with lab-related outbreaks
	***~~Aerial~~ hyphae with macroconidia, which are its identifying feature		***Septate hyaline mold with aerial hyphae with macroconidia, which are its identifying feature
	***Two types of conidia: tuberculate macroconidia (ovoid bodies 8 to 15 μm with spikes), and microconidia (small, smooth oval bodies 2 to 5 μm)		***Two types of conidia: tuberculate macroconidia (ovoid bodies 8 to 15 μm with spikes), and microconidia (small, smooth oval bodies 2 to 5 μm)
	***Two colony types, brown (B) and albino (A)		***Two colony types, brown (B) and albino (A)
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	\|}		\|}

	* '''Note:''' therapeutic drug level monitoring is recommended for itraconazole		*'''Note:''' therapeutic drug level monitoring is recommended for itraconazole
	* '''Source:''' IDSA guidelines 2007		*'''Source:''' IDSA guidelines 2007

	== Prevention ==		==Prevention==

	=== Lab Safety ===		===Lab Safety===

	* [[Biosafety risk groups\|Biosafety risk group 3]] organism		*[[Biosafety risk groups\|Biosafety risk group 3]] organism
	{{DISPLAYTITLE:''Histoplasma capsulatum''}}		{{DISPLAYTITLE:''Histoplasma capsulatum''}}
	[[Category:Dimorphic fungi]]		[[Category:Dimorphic fungi]]

Aidan at 12:42, 10 September 2020

2020-09-10T12:42:03Z

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Aidan: /* Management */

2020-08-14T10:04:54Z

Management

← Older revision		Revision as of 10:04, 14 August 2020
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	*In general, mild infections are treated with [[Is treated by::itraconazole]] and severe infections with [[Is treated by::amphotericin B]]		*In general, mild infections are treated with [[Is treated by::itraconazole]] and severe infections with [[Is treated by::amphotericin B]]
			*Indications for antifungal therapy
			**Definitely: moderate to severe acute diffuse pulmonary infection, chronic cavitary pulmonary disease, disseminated disease, CNS infection
			**Possibly: asymptomatic, mild symptoms lasting longer than 1 month, acute focal pulmonary infection, mediastinal lymphadenitis, mediastinal granuloma
			**Not recommended: mediastinal fibrosis, pulmonary nodule, broncholithiasis, presumed ocular histoplasmosis syndrome

	{\| class="wikitable"		{\| class="wikitable"
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	!Treatment		!Treatment
	\|-		\|-
	\|Acute pulmonary histoplasmosis		\| colspan="2" \|Acute pulmonary histoplasmosis
	\|
	\|-		\|-
	\| Mild, self-resolving		\| Mild, self-resolving
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	\|[[Itraconazole]] 200 mg TID x3d then daily or BID for at least 1 year (18-24 months may have lower relapse)		\|[[Itraconazole]] 200 mg TID x3d then daily or BID for at least 1 year (18-24 months may have lower relapse)
	\|-		\|-
	\|Complications		\| colspan="2" \|Complications
	\|
	\|-		\|-
	\| Pericarditis		\| Pericarditis

Aidan: /* Epidemiology */

2020-08-14T09:57:25Z

Epidemiology

Show changes

Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"

2020-07-20T00:08:25Z

Text replacement - "Clinical Presentation" to "Clinical Manifestations"

← Older revision		Revision as of 00:08, 20 July 2020
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	* In impaired cellular immunity, infection can become disseminated		* In impaired cellular immunity, infection can become disseminated

	== Clinical ~~Presentation~~ ==		== Clinical Manifestations ==

	* Often asymptomatic; in endemic areas, 50-80% of people skin-test positive or have radiographic evidence of previous infection		* Often asymptomatic; in endemic areas, 50-80% of people skin-test positive or have radiographic evidence of previous infection

Aidan: rearranged sections

2020-02-13T20:34:03Z

rearranged sections

← Older revision		Revision as of 20:34, 13 February 2020
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	== ~~Microbiology~~ ==		== Background ==
			=== Microbiology ===

	* Dimorphic fungus; mold at room temperature, yeast at >37º C		* Dimorphic fungus; mold at room temperature, yeast at >37º C
	** Mold: aerial hyphae with macroconidia		** Mold: aerial hyphae with macroconidia
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	** Can take up to 7 days to grow		** Can take up to 7 days to grow

	== Epidemiology ==		=== Epidemiology ===

	[[File:Histoplasmosis_map.png\|thumb\|Distribution of histoplasmosis]]		[[File:Histoplasmosis_map.png\|thumb\|Distribution of histoplasmosis]]

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	** Disturbing the soil aerosolizes it, allowing the microconidia to be inhaled		** Disturbing the soil aerosolizes it, allowing the microconidia to be inhaled

	== Pathophysiology ==		=== Pathophysiology ===

	* Inhaled microconidia reach the alveolii and are phagocytosed by alveolar macrophages		* Inhaled microconidia reach the alveolii and are phagocytosed by alveolar macrophages

Aidan: /* Epidemiology */

2020-02-13T20:33:31Z

Epidemiology

← Older revision		Revision as of 20:33, 13 February 2020
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	== Epidemiology ==		== Epidemiology ==

			[[File:Histoplasmosis_map.png\|thumb\|Distribution of histoplasmosis]]

	* Endemic in many parts of the world		* Endemic in many parts of the world