Histoplasmosis is an infection caused by a fungus. It is commonly found in the soil in parts of the Midwestern United States, Haiti and in the southern parts
of Ontario and Quebec where there is contamination with bird and bat droppings. This may include buildings where birds and bats nest. It is relatively rare in most other parts of Canada. This fungus enters
the body most commonly through the lungs (breathing in particles of the contaminated soil). It can be in your body for several years and then start to cause symptoms as the immune system weakens. Symptoms of
Histoplasmosis do not usually appear until the CD4 counts have dropped below 100. It is not contagious from one person to another.
What do I look for?
Histoplasmosis may be very slow in
developing, so at first very vague symptoms will appear: fever, fatigue, weight loss. As the infection progresses more symptoms will appear if it is not treated: shortness of breath & cough, skin rash,
swollen liver or spleen, swollen lymph nodes, low white blood cell count, anemia (low hemoglobin), headaches, confusion & seizures.
Can Histoplasmosis be prevented?
In areas where this
infection is very common, most people have already been exposed to the fungus that causes it. No special precautions can be taken to prevent the infection. At present, there are no proven medications that
decrease the risk of histoplasmosis infection.
How is Histoplasmosis treated?
Early detection and reporting of symptoms are the best ways to ensure that treatment is started as soon as possible.
There are medications that are available to fight this fungal infection. The most common treatments include: amphotericin B (given by intravenous) and itraconazole (Sporanox) pills taken by mouth At first,
medications may have to be given intravenously (directly into the vein). Because this infection tends to come back even after it has been treated, it is recommended that you remain on one of these
anti-fungal medications for life, to keep the infection from coming back.
References
Cohen, P.T., Sande, Merle and Volberding, Paul. (1994). The AIDS Knowledge Base, 2nd ed.
Philips, Peter. (1994). "Fungal infections in AIDS patients", Grand Rounds in Infectious Diseases, 4, (10), 5-11.
Sande, Merle and Volberding, Paul. (1992). The Medical Management of AIDS, 3rd ed.
Philadelphia: W.B. Saunders Co.
Wheat, Joseph. (1994). "Histoplasmosis...in individuals with AIDS" in Infectious Disease Clinics of North America, 8, (2), 467-482.
