Histoplasmosis

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Histoplasmosis
Other names: Cave disease, Darling's disease, Ohio valley disease, reticuloendotheliosis,[1] spelunker's lung, caver's disease, histoplasma infection[2]
Skin lesion on the upper lip due to histoplasmosis
SpecialtyInfectious disease[3]
SymptomsNone, fever, headache, nonproductive cough, chest pain[4]
TypesPrimary pulmonary, progressive disseminated, primary cutaneous, African[5]
CausesHistoplasma capsulatum.[6]
Diagnostic methodImaging, BAL, and enzyme immunoassays[4]
Differential diagnosisFungal pneumonia, blastomycosis, carcinoid lung tumour, chlamydial pneumonia, legionella pneumonia[4]
TreatmentItraconazole[4]
Frequency15 per million/yr (southern USA)[7]

Histoplasmosis is a fungal infection caused by Histoplasma capsulatum.[6][8] Symptoms range widely, but primarily involve the lungs.[9] Occasionally, other organs are affected; known as disseminated histoplasmosis, which can be fatal if left untreated.[10]

Histoplasma capsulatum is found in soil, often associated with decaying bat or bird droppings.[11][12] Disruption of soil from excavation or construction can release infectious elements that are inhaled and settle into the lung. Histoplasmosis is common among AIDS patients because of their suppressed immunity. In immunocompetent individuals, past infection results in partial protection against ill effects if reinfected.[11][4][13][12]

Early diagnosis is via a urine Histoplasma antigen test.[14][15] This can be confirmed by isolating the fungus from sputum, bone marrow, bronchial washings, cerebrospinal fluid, or blood, but this can take up to 8 weeks.[14] Other tests may include serological tests or PCR.[14]

Histoplasmosis affects about 15 per million people per year in the southern United States.[7] Between 2001 and 2012, admissions to hospital in North America almost doubled due to the infection.[16] Among those who are hospitalized about 6% die.[7] In 1978-1979 during a large urban outbreak 100,000 people were exposed in Indianapolis, and people developed pericarditis, rheumatological problems, esophageal and vocal cord ulcers, parotitis, adrenal insufficiency, uveitis, fibrosing mediastinitis, interstitial nephritis, intestinal lymphangiectasia, and epididymitis.[17][4][18]

Signs and symptoms

Presumed histoplasmosis of the eye

If symptoms of histoplasmosis infection occur, they start within 3 to 17 days after exposure; the typical time is 12–14 days. Most affected individuals have clinically silent manifestations and show no apparent ill effects. The acute phase of histoplasmosis is characterized by nonspecific respiratory symptoms, often cough or flu-like. Chest X-ray findings are normal in 40–70% of cases.[19] Chronic histoplasmosis cases can resemble tuberculosis;[20][21] disseminated histoplasmosis affects multiple organ systems and is fatal unless treated.[22]

While histoplasmosis is a cause of mediastinitis, this remains a relatively rare disease. Severe infections can cause hepatosplenomegaly, lymphadenopathy. Lesions have a tendency to calcify as they heal.[23][9][24]

Presumed ocular histoplasmosis syndrome causes chorioretinitis, where the choroid and retina of the eyes are scarred, resulting in a loss of vision not unlike macular degeneration. Despite its name, the relationship to Histoplasma is controversial.[25][26] Distinct from POHS, acute ocular histoplasmosis may rarely occur in immunodeficiency.[27][28]

Complications

In absence of proper treatment and especially in immunocompromised individuals, complications can arise.[29] These include respiratory failure, fibrosing mediastinitis, pulmonary vessel obstruction, and progressive fibrosis. Smokers with structural lung disease have higher probability of developing chronic cavitary histoplasmosis;after healing of lesions, hard, calcified lymph nodes can erode the walls of the airway, causing hemoptysis.[30][31][32][22]

Mechanisms

H. capsulatum grows in soil and material contaminated with bird or bat droppings (guano). The fungus has been found in poultry-house litter, caves, areas harboring bats, and bird roosts (particularly those of starlings). The fungus is thermally dimorphic; in the environment, it grows as a brownish mycelium, and at body temperature (37°C in humans), it morphs into a yeast. Histoplasmosis is not contagious, but is contracted by inhalation of the spores from disturbed soil or guano.[9] [4][33]

The inoculum is represented principally by microconidia. These are inhaled and reach the alveoli, in the alveoli, macrophages ingest these microconidia, they survive inside the phagosome. As the fungus is thermally dimorphic, these microconidia are transformed into yeast. They grow and multiply inside the phagosome. The macrophages travel in lymphatic circulation and can spread the disease to different organs.Within the phagosome, the fungus has an absolute requirement for thiamine.Cell-mediated immunity for histoplasmosis develops within 2 weeks. If the patient has strong cellular immunity, macrophages, epithelial cells, and lymphocytes surround the organisms and contain them, and eventually calcify. In immunocompromised individuals, the organisms disseminate to different organs such as bone, spleen, liver, adrenal glands, and mucocutaneous membranes, resulting in progressive disseminated histoplasmosis. Chronic lung disease can manifest.[34][4][33][35]

  • Pathogenesis of histoplasmosis.[36]

    Pathogenesis of histoplasmosis.[36]

  • Phylogeny and haplotype among Histoplasma capsulatum genotypes[37]

    Phylogeny and haplotype among Histoplasma capsulatum genotypes[37]

Diagnosis

Chest X-ray of acute pulmonary histoplasmosis

Clinically, a wide spectrum of disease manifestations occurs, making diagnosis somewhat difficult. More severe forms include the chronic pulmonary form, often occurring in the presence of underlying pulmonary disease, and a disseminated form, which is characterized by the progressive spread of infection to extrapulmonary sites. Oral manifestations have been reported as the main complaint of the disseminated forms, leading the patient to seek treatment, whereas pulmonary symptoms in disseminated disease may be mild or even misinterpreted as flu. Histoplasmosis can be diagnosed by samples containing the fungus taken from sputum , blood, or infected organs. It can also be diagnosed by detection of antigens in blood or urine samples by ELISA or polymerase chain reaction. Antigens can cross-react with antigens of African histoplasmosis, blastomycosis, coccidioidomycosis, paracoccidioidomycosis, and talaromycosis infection.[38][39][4][40]

Histoplasmosis can also be diagnosed by a test for antibodies against Histoplasma in the blood. [41]

Histoplasma skin tests indicate whether persons have been exposed, but do not indicate whether they have the disease.[9] Formal histoplasmosis diagnoses are often confirmed only by culturing the fungus directly.[11] Sabouraud agar is one agar growth medium on which the fungus can be cultured. Cutaneous manifestations of disseminated disease are diverse and often present as a nondescript rash with systemic complaints. Diagnosis is best established by urine antigen testing, as blood cultures may take up to 6 weeks for diagnostic growth to occur and serum antigen testing often comes back with a false negative before 4 weeks of disseminated infection.[42]

Types

Histoplasmosis may be divided into four types:[5]: 316–317 

  • Histoplasma capsulatum var. duboisii

    Histoplasma capsulatum var. duboisii

  • Jamaican isolate of Histoplasma capsulatum

    Jamaican isolate of Histoplasma capsulatum

  • Histoplasma capsulatum. Methenamine silver stain showing histopathologic changes in histoplasmosis

    Histoplasma capsulatum. Methenamine silver stain showing histopathologic changes in histoplasmosis

Differential diagnosis

Blastomycosis

The DDx includes:[4]

Prevention

Testing or decontaminating most sites that may be contaminated with H. capsulatum is impractical, but the sources below list environments where histoplasmosis is common, and precautions to reduce a person's risk of exposure, in the three parts of the world where the disease is prevalent. Precautions common to all geographical locations would be to avoid accumulations of bird droppings.[43][44]

The US National Institute for Occupational Safety and Health provides information on work practices and personal protective equipment that may reduce the risk of infection.[45]

A review paper includes information on locations in which Histoplasmosis has been found in Africa (in chicken runs, on bats, in the caves bats infest, and in soil), and a thorough reference list including English, French, and Spanish language references.[46]

Treatment

Amphotericin B

In the majority of immunocompetent individuals, histoplasmosis resolves without any treatment. Antifungal medications are used to treat severe cases of acute histoplasmosis and all cases of chronic and disseminated disease. Typical treatment of severe disease is with amphotericin B, followed by itraconazole by mouth.[47][10][48]

Liposomal preparations of amphotericin B are more effective than deoxycholate preparations. The liposomal preparation is preferred in patients who might be at risk of nephrotoxicity, although all preparations of amphotericin B have risk of nephrotoxicity. Individuals taking amphotericin B are monitored for renal function.[49] Liposomal amphotericin B is better at treating people with progressive disseminated Histoplasmosis and underlying HIV when compared to deoxycholate amphotericin B. Meanwhile, fluconazole performs poorly when compared to other azoles.[50]

Treatment with itraconazole must continue for at least a year in severe cases, while in acute pulmonary Histoplasmosis, 6 to 12 weeks treatment is sufficient. Alternatives to itraconazole are posaconazole, voriconazole, and fluconazole. Individuals taking itraconazole are monitored for hepatic function.[51][47][52]

Prognosis

In terms of the prognosis we find that it depends on the severity of the infection and the individuals health.Untreated progressive disseminated histoplasmosis can have a mortality rate greater than 90%.[53]

Epidemiology

H. capsulatum is found throughout the world. It is endemic in certain areas of the United States, particularly in states bordering the Ohio River valley and the lower Mississippi River. The humidity and acidity patterns of soil are associated with endemicity. Bird and bat droppings in soil promote growth of Histoplasma. Contact with such soil aerosolizes the microconidia, which can infect humans. It is also common in caves in Southern and East Africa. Positive Histoplasmin skin tests occur in as many as 90% of the people living in areas where H. capsulatum is common, such as the eastern and central United States.[9]

In Canada, the St. Lawrence River Valley is the site of the most frequent infections, with 20–30% of the population testing positive.[54]

A review of reported cases in 2018 showed disease presence throughout Southeast Asia,[55]

In India, the Gangetic West Bengal is the site of most frequent infections, with 9.4% of the population testing positive.[56]

H. c. capsulatum was isolated from the local soil proving endemicity of Histoplasmosis in West Bengal.[57]

  • Histoplasmosis endemism map for U.S.[58]

    Histoplasmosis endemism map for U.S.[58]

  • Global distribution patterns of 436 Histoplasma spp. isolates[37]

    Global distribution patterns of 436 Histoplasma spp. isolates[37]

History

Samuel Taylor Darling PhD

Histoplasma was discovered in 1905 by Samuel T. Darling,[59] but only in the 1930s was it discovered to be a widespread infection.

Before then, many cases of Histoplasmosis were mistakenly attributed to tuberculosis, and patients were mistakenly admitted to tuberculosis sanatoria. Some patients contracted tuberculosis in these sanatoriums.[60]

Society and culture

In terms of culture and society we find the following:

  • Johnny Cash included a reference to the disease, even correctly noting its source in bird droppings, in the song "Beans for Breakfast".[61]
  • Bob Dylan was hospitalized due to Histoplasmosis in 1997, causing the cancellation of concerts in the United Kingdom and Switzerland.[62]
  • In episode five of season one of the television series Dexter, Vince Masuka gets worried about getting Histoplasmosis from the dust in the air and the hair of the rats.[63]
  • In the BBC drama Call The Midwife's 9th season, a character is diagnosed with the disease after initial confusion regarding whether his symptoms were more indicative of tuberculosis. He contracts it from the droppings of pet pigeons he keeps in his home.[64]

See also

References

  1. ↑ Rapini RP, Bolognia JL, Jorizzo JL (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  2. ↑ "Histoplasmosis (Concept Id: C0019655) - MedGen - NCBI". www.ncbi.nlm.nih.gov. Archived from the original on 22 January 2022. Retrieved 30 November 2024.
  3. ↑ "ICD-11 - ICD-11 for Mortality and Morbidity Statistics". icd.who.int. Archived from the original on 2018-08-01. Retrieved 2021-06-18.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 Akram, Sami M.; Koirala, Janak (2024). "Histoplasmosis". StatPearls. StatPearls Publishing. Archived from the original on 2023-08-11. Retrieved 2024-11-29.
  5. ↑ 5.0 5.1 James WD, Berger TG, et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
  6. ↑ 6.0 6.1 Johnstone, Ronald B. (2017). "25. Mycoses and Algal infections". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 452. ISBN 978-0-7020-6830-0. Archived from the original on 2021-05-25. Retrieved 2021-06-18.
  7. ↑ 7.0 7.1 7.2 "Facts and Stats About Histoplasmosis". Histoplasmosis. CDC. 23 April 2024. Archived from the original on 29 September 2024. Retrieved 13 December 2024.
  8. ↑ Stenn F (February 1960). "Cave disease or speleonosis". Archives of Internal Medicine. 105 (2): 181–3. doi:10.1001/archinte.1960.00270140003001. PMID 13834312.
  9. ↑ 9.0 9.1 9.2 9.3 9.4 Ryan KJ, Ray CG, eds. (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 674–6. ISBN 978-0-8385-8529-0.
  10. ↑ 10.0 10.1 Histoplasmosis: Fungal Infections at Merck Manual of Diagnosis and Therapy Home Edition
  11. ↑ 11.0 11.1 11.2 Cotran RS, Kumar V, Fausto N, Robbins SL, Abbas AK (2005). Robbins and Cotran Pathologic Basis of Disease. St. Louis: Elsevier/Saunders. pp. 754–5. ISBN 978-0-7216-0187-8.
  12. ↑ 12.0 12.1 Toscanini, María Agustina; Nusblat, Alejandro David; Cuestas, María Luján (March 2021). "Diagnosis of histoplasmosis: current status and perspectives". Applied Microbiology and Biotechnology. 105 (5): 1837–1859. doi:10.1007/s00253-021-11170-9. ISSN 1432-0614. PMID 33587157. Archived from the original on 2023-05-18. Retrieved 2023-06-16.
  13. ↑ Myint, Thein; Leedy, Nicole; Villacorta Cari, Evelyn; Wheat, L. Joseph (2020). "HIV-Associated Histoplasmosis: Current Perspectives". HIV/AIDS (Auckland, N.Z.). 12: 113–125. doi:10.2147/HIV.S185631. ISSN 1179-1373. Archived from the original on 2024-03-07. Retrieved 2024-12-10.
  14. ↑ 14.0 14.1 14.2 Seagle, Emma E.; Williams, Samantha L.; Chiller, Tom L. (2021). "Recent trends in the epidemiology of fungal infections". In Ostrosky-Zeichner, Luis (ed.). Fungal Infections, An Issue of Infectious Disease Clinics of North America. Philadelphia: Elsevier. pp. 479–481. ISBN 978-0-323-81294-8. Archived from the original on 2021-09-03. Retrieved 2021-09-03.
  15. ↑ "The selection and use of essential in vitro diagnostics - 2020". www.who.int. World Health Organization. pp. 254–256. Archived from the original on 20 August 2021. Retrieved 20 August 2021.
  16. ↑ Seagle, Emma E.; Williams, Samantha L.; Chiller, Tom L. (2021). "Recent trends in the epidemiology of fungal infections". In Ostrosky-Zeichner, Luis (ed.). Fungal Infections, An Issue of Infectious Disease Clinics of North America. Philadelphia: Elsevier. p. 240. ISBN 978-0-323-81294-8. Archived from the original on 2021-09-03. Retrieved 2021-09-03.
  17. ↑ "Indianapolis city government". Archived from the original on 2021-01-17. Retrieved 2021-06-06.
  18. ↑ Wheat, L. J.; Slama, T. G.; Eitzen, H. E.; Kohler, R. B.; French, M. L.; Biesecker, J. L. (March 1981). "A large urban outbreak of histoplasmosis: clinical features". Annals of Internal Medicine. 94 (3): 331–337. doi:10.7326/0003-4819-94-3-331. ISSN 0003-4819. Archived from the original on 2024-12-10. Retrieved 2024-12-14.
  19. ↑ Silberberg P (2007-03-26). "Radiology Teaching Files: Case 224856 (Histoplasmosis)". Archived from the original on 2016-03-03. Retrieved 2007-07-27.
  20. ↑ Tong P, Tan WC, Pang M (September 1983). "Sporadic disseminated histoplasmosis simulating miliary tuberculosis". British Medical Journal. 287 (6395): 822–3. doi:10.1136/bmj.287.6395.822. PMC 1549119. PMID 6412842.
  21. ↑ Gari-Toussaint, Marty P, Le Fichoux Y, Loubière R (1987). "Histoplasmose d'importation à Histoplasma capsulatum, données biocliniques et thérapeutiques variées, à propos de trois cas observés dans les Alpes maritimes". Bull Soc Fr Mycol Med. 16 (1): 87–90. Archived from the original on 2012-04-06. Retrieved 2021-06-06.
  22. ↑ 22.0 22.1 Kauffman CA (January 2007). "Histoplasmosis: a clinical and laboratory update". Clinical Microbiology Reviews. 20 (1): 115–32. doi:10.1128/CMR.00027-06. PMC 1797635. PMID 17223625.
  23. ↑ Kappus, Sarah; King, Orinthia (2024). "Mediastinitis". StatPearls. StatPearls Publishing.
  24. ↑ "Histoplasmosis Clinical Presentation: History, Physical Examination, Complications". emedicine.medscape.com. Archived from the original on 2024-04-06. Retrieved 2024-12-13.
  25. ↑ Thuruthumaly C, Yee DC, Rao PK (November 2014). "Presumed ocular histoplasmosis". Current Opinion in Ophthalmology. 25 (6): 508–12. doi:10.1097/ICU.0000000000000100. PMID 25237930. S2CID 43761401.
  26. ↑ Nielsen JS, Fick TA, Saggau DD, Barnes CH (March 2012). "Intravitreal anti-vascular endothelial growth factor therapy for choroidal neovascularization secondary to ocular histoplasmosis syndrome". Retina. 32 (3): 468–72. doi:10.1097/IAE.0b013e318229b220. PMID 21817958. S2CID 25507234.
  27. ↑ Macher A, Rodrigues MM, Kaplan W, Pistole MC, McKittrick A, Lawrinson WE, Reichert CM (August 1985). "Disseminated bilateral chorioretinitis due to Histoplasma capsulatum in a patient with the acquired immunodeficiency syndrome". Ophthalmology. 92 (8): 1159–64. doi:10.1016/s0161-6420(85)33921-0. PMID 2413418.
  28. ↑ Gonzales CA, Scott IU, Chaudhry NA, Luu KM, Miller D, Murray TG, Davis JL (April 2000). "Endogenous endophthalmitis caused by Histoplasma capsulatum var. capsulatum: a case report and literature review". Ophthalmology. 107 (4): 725–9. doi:10.1016/s0161-6420(99)00179-7. PMID 10768335.
  29. ↑ Dao, Aiken; Kim, Hannah Yejin; Halliday, Catriona L; Oladele, Rita; Rickerts, Volker; Govender MMed, Nelesh P; Shin, Jong-Hee; Heim, Jutta; Ford, Nathan Paul; Nahrgang, Saskia Andrea; Gigante, Valeria; Beardsley, Justin; Sati, Hatim; Morrissey, C Orla; Alffenaar, Jan-Willem; Alastruey-Izquierdo, Ana (27 June 2024). "Histoplasmosis: A systematic review to inform the World Health Organization of a fungal priority pathogens list" (PDF). Medical Mycology. 62 (6). doi:10.1093/mmy/myae039.
  30. ↑ Linder, Kathleen A.; Kauffman, Carol A. (1 September 2019). "Histoplasmosis: Epidemiology, Diagnosis, and Clinical Manifestations". Current Fungal Infection Reports. 13 (3): 120–128. doi:10.1007/s12281-019-00341-x. ISSN 1936-377X. Archived from the original on 28 July 2024. Retrieved 13 December 2024.
  31. ↑ Knox, Kenneth S.; Hage, Chadi A. (15 May 2010). "Histoplasmosis". Proceedings of the American Thoracic Society. 7 (3): 169–172. doi:10.1513/pats.200907-069AL. ISSN 1546-3222. Retrieved 14 December 2024.
  32. ↑ Wang, Aqian; Su, Hongling; Duan, Yichao; Jiang, Kaiyu; Li, Yu; Deng, Mingjun; Long, Xiaozhou; Wang, Haijun; Zhang, Min; Zhang, Yan; Cao, Yunshan (June 2022). "Pulmonary Hypertension Caused by Fibrosing Mediastinitis". JACC: Asia. 2 (3): 218–234. doi:10.1016/j.jacasi.2021.11.016.
  33. ↑ 33.0 33.1 Mittal, Jamie; Ponce, Maria G.; Gendlina, Inessa; Nosanchuk, Joshua D. (2018). "Histoplasma Capsulatum: Mechanisms for Pathogenesis". Fungal Physiology and Immunopathogenesis. 422: 157–191. doi:10.1007/82_2018_114.
  34. ↑ Garfoot AL, Zemska O, Rappleye CA (2013) Histoplasma capsulatum depends on de novo vitamin biosynthesis for intraphagosomal proliferation. Infect Immum
  35. ↑ Valdez, Alessandro F.; Miranda, Daniel Zamith; Guimarães, Allan Jefferson; Nimrichter, Leonardo; Nosanchuk, Joshua D. (31 December 2022). "Pathogenicity & virulence of Histoplasma capsulatum - A multifaceted organism adapted to intracellular environments". Virulence. 13 (1). doi:10.1080/21505594.2022.2137987. Archived from the original on 11 December 2024. Retrieved 14 December 2024.
  36. ↑ Barros, Nicolas; Wheat, L. Joseph (2 February 2024). "Histoplasmosis in Solid Organ Transplantation". Journal of Fungi. 10 (2): 124. doi:10.3390/jof10020124.
  37. ↑ 37.0 37.1 Rodrigues, A.M.; Beale, M.A.; Hagen, F.; Fisher, M.C.; Terra, P.P.D.; de Hoog, S.; Brilhante, R.S.N.; de Aguiar Cordeiro, R.; de Souza Collares Maia Castelo-Branco, D.; Rocha, M.F.G.; Sidrim, J.J.C.; de Camargo, Z.P. (September 2020). "The global epidemiology of emerging Histoplasma species in recent years". Studies in Mycology. 97: 100095. doi:10.1016/j.simyco.2020.02.001.
  38. ↑ "Histoplasmosis: MedlinePlus Medical Encyclopedia". medlineplus.gov. Archived from the original on 30 November 2024. Retrieved 3 December 2024.
  39. ↑ Brazão-Silva MT, Mancusi GW, Bazzoun FV, Ishisaaki GY, Marcucci M. A gingival manifestation of histoplasmosis leading diagnosis. Contemp Clin Dent. V.4 (1). 2013 (http://www.contempclindent.org/text.asp?2013/4/1/97/111621 Archived 2018-06-02 at the Wayback Machine)
  40. ↑ Guidelines for Diagnosing and Managing Disseminated Histoplasmosis among People Living with HIV. Pan American Health Organization. 2020. ISBN 978-92-75-12248-8.
  41. ↑ Ashraf, Nida; Kubat, Ryan C.; Poplin, Victoria; Adenis, Antoine A.; Denning, David W.; Wright, Laura; McCotter, Orion; Schwartz, Ilan S.; Jackson, Brendan R.; Chiller, Tom; Bahr, Nathan C. (October 2020). "Re-drawing the Maps for Endemic Mycoses". Mycopathologia. 185 (5): 843–865. doi:10.1007/s11046-020-00431-2. ISSN 1573-0832. PMID 32040709. Archived from the original on 2021-04-19. Retrieved 2021-08-28.
  42. ↑ Rosenberg JD, Scheinfeld NS (December 2003). "Cutaneous histoplasmosis in patients with acquired immunodeficiency syndrome". Cutis. 72 (6): 439–45. PMID 14700213.
  43. ↑ "Reducing Risk for Histoplasmosis". Histoplasmosis. 14 May 2024. Archived from the original on 27 September 2024. Retrieved 3 December 2024.
  44. ↑ "Histoplasmosis". www.health.ny.gov. Archived from the original on 17 September 2024. Retrieved 6 December 2024.
  45. ↑ "CDC - NIOSH Publications and Products - Histoplasmosis - Protecting Workers at Risk (2005-109)". web.archive.org. 10 December 2017. Archived from the original on 10 December 2017. Retrieved 13 December 2024.{{cite web}}: CS1 maint: bot: original URL status unknown (link)
  46. ↑ Gugnani HC, Muotoe-Okafor F (December 1997). "African Histoplasmosis: a review" (PDF). Revista Iberoamericana de Micologia. 14 (4): 155–9. PMID 15538817. Archived (PDF) from the original on 2017-08-13. Retrieved 2021-06-06.open access
  47. ↑ 47.0 47.1 Wheat LJ, Freifeld AG, Kleiman MB, Baddley JW, McKinsey DS, Loyd JE, Kauffman CA (October 2007). "Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America". Clinical Infectious Diseases. 45 (7): 807–25. doi:10.1086/521259. PMID 17806045.
  48. ↑ Kurowski, Rene; Ostapchuk, Michael (15 December 2002). "Overview of Histoplasmosis". American Family Physician. 66 (12): 2247–2253. Archived from the original on 23 June 2024. Retrieved 4 December 2024.
  49. ↑ Moen MD, Lyseng-Williamson KA, Scott LJ (2009). "Liposomal amphotericin B: a review of its use as empirical therapy in febrile neutropenia and in the treatment of invasive fungal infections". Drugs. 69 (3): 361–92. doi:10.2165/00003495-200969030-00010. PMID 19275278. S2CID 34340503.
  50. ↑ Murray M, Hine P, et al. (Cochrane Infectious Diseases Group) (April 2020). "Treating progressive disseminated Histoplasmosis in people living with HIV". The Cochrane Database of Systematic Reviews. 4: CD013594. doi:10.1002/14651858.CD013594. PMC 7192368. PMID 32343003.
  51. ↑ Barron MA, Madinger NE (November 18, 2008). "Opportunistic Fungal Infections, Part 3: Cryptococcosis, Histoplasmosis, Coccidioidomycosis, and Emerging Mould Infections". Infections in Medicine. Archived from the original on March 14, 2010. Retrieved June 6, 2021.
  52. ↑ "Histoplasmosis: Adult and Adolescent OIs | NIH". clinicalinfo.hiv.gov. 29 October 2024. Archived from the original on 28 November 2024. Retrieved 11 December 2024.
  53. ↑ "Histoplasmosis - Histoplasmosis". Merck Manual Professional Version. Retrieved 6 December 2024.
  54. ↑ "Histoplasmosis". www.ccohs.ca. Canadian Centre for Occupational Health & Safety. July 1, 2013. Archived from the original on October 27, 2018. Retrieved June 6, 2021.
  55. ↑ Baker J, Setianingrum F, Wahyuningsih R, Denning DW (Jan 2019). "Mapping Histoplasmosis in South East Asia - implications for diagnosis in AIDS". Emerging Microbes & Infections. 8 (1): 1139–1145. doi:10.1080/22221751.2019.1644539. PMC 6711083. PMID 31364950.
  56. ↑ Sanyal M, Thammayya A (July 1975). "Histoplasma capsulatum in the soil of Gangetic Plain in India". The Indian Journal of Medical Research. 63 (7): 1020–8. PMID 1213788.
  57. ↑ Sanyal M, Thammayya A (1980). "Skin Sensitivity To Histoplasmin in Calcutta and Its Neighbourhood". Indian Journal of Dermatology, Venereology and Leprology. 46 (2): 94–98. PMID 28218139.
  58. ↑ "Areas with Histoplasmosis". Histoplasmosis. 15 May 2024. Retrieved 3 December 2024.
  59. ↑ Darling ST (1906). "A protozoan general infection producing pseudotubercles in the lungs and focal necrosis in the liver, spleen and lymphnodes". J Am Med Assoc. 46 (17): 1283–5. doi:10.1001/jama.1906.62510440037003. Archived from the original on 2021-08-28. Retrieved 2021-06-06.
  60. ↑ Bennett JE, Dolin R, Blaser MJ (11 September 2014). Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases" (8th ed.). ISBN 978-1455748013.
  61. ↑ Kroll, David (6 March 2014). "Solving The Mystery Of 'Bamboo Bonfire' Lung Disease". Forbes. Archived from the original on 2017-11-07. Retrieved 2017-11-04.
  62. ↑ "CNN - Bob Dylan hospitalized with chest infection - May 28, 1997". web.archive.org. 26 October 2007. Archived from the original on 26 October 2007. Retrieved 13 December 2024.{{cite web}}: CS1 maint: bot: original URL status unknown (link)
  63. ↑ Goldman, Eric (October 30, 2006). "Dexter: "Love American Style" Review". IGN. Retrieved 2009-04-16.
  64. ↑ "What is histoplasmosis? Call the Midwife disease explained | Radio Times". www.radiotimes.com. Retrieved 5 December 2024.

External links

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External resources
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