Lung infection

[Robbie813]

What is the treatment for Histoplasmosis?

[jkwrabbit]

I was diagnosed with histolasmosis earlier this year.  A 1.2cm x 1.5cm module was discovered on a routine chest x-ray. A PET scan was then done to see if the nodule "lights up".  I had uptake in the nodule and also in the lymph nodes.  They were very concerned that it was lung cancer.  They did a biopsy of the lymph nodes in my chest and it came back positive for histo.  The surgeon was still not convinced that the nodule wasn't cancer, so he did a VATS and took out a piece of my lung (along with the nodule).  It wasnt' cancer, just more histo.  Because the scan showed activity, they put me on itraconazole for three months, but normally they don't treat it.  Your body should fight it off unless you have a compromised immune system.

[National Jewish Health]

There may be additional treatment for non-pulmonary histoplasmosis such as that which involves the eye(s), called ocular histoplasmosis.

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The following is from Cecil's Textbook of Medicine 2007

Pulmonary Histoplasmosis
Acute pulmonary histoplasmosis is usually a self-limited disease.  Patients who require treatment generally respond promptly to antifungal agents.  However, the response of patients with chronic cavitary pulmonary histoplasmosis is often poor, primarily because of their severe underlying pulmonary disease.  Patients with disseminated histoplasmosis, even those with advanced AIDS, usually respond promptly to antifungal therapy.  Older patients with chronic progressive disseminated histoplasmosis have a slower, but usually complete response to therapy.

Treatment is not usually given for acute pulmonary histoplasmosis; many times the diagnosis is not made until after the symptoms have resolved.  However, if the patient remains symptomatic after 4 weeks, therapy with itraconazole, 200 mg daily for 6 to 12 weeks, can be given.  Patients who have severe outbreak-associated histoplasmosis and all immunosuppressed patients should be treated.  Initial therapy with amphotericin B, 0.7 to 1 mg/kg daily, can be followed by oral itraconazole after a favorable response is noted.  Antifungal therapy should be given to all patients with chronic pulmonary histoplasmosis.  Itraconazole, 200 mg once or twice
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