Pediatric Histoplasmosis Follow-up

  • Author: James S Hagood, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Apr 23, 2012
 

Prognosis

  • Most cases of histoplasmosis spontaneously resolve and do not recur.
  • Reinfection is possible, as is reactivation in individuals from endemic areas who become immunosuppressed.
  • The mortality rate of disseminated disease even with appropriate treatment is high (7-23%); without treatment it is as high as 80%.
  • Poor clinical response or relapse may indicate insufficient total dose of antifungal agent, unrecognized immunosuppression, or occult localized infection, such as endocarditis or meningitis.
  • Relapse occurs in 10-20% of patients with disseminated infection and in as many as 80% of those with AIDS.
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Patient Education

  • Prevention of histoplasmosis can be difficult because the source of organisms cannot always be determined, although reports of decontamination of environmental sources have been reported.
  • Immunocompromised individuals should be counseled to avoid situations in which the likelihood of exposure is high, such as spelunking or outdoor construction projects in endemic areas where significant disturbance of soil occurs.
  • For excellent patient education resources, visit eMedicine's Procedures Center. Also, see eMedicine's patient education article Bronchoscopy.
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Contributor Information and Disclosures
Author

James S Hagood, MD  Professor of Pediatrics and Chief, Division of Respiratory Medicine, Department of Pediatrics, University of California, San Diego, School of Medicine and Rady Children's Hospital of San Diego

James S Hagood, MD is a member of the following medical societies: American Thoracic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Asad Ansari, MD, MPH  Attending Physician, Pediatric Pulmonology and Infectious Diseases, Memorial Children's Hospital, South Bend, Indiana

Asad Ansari, MD, MPH is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Gulnur Com, MD  Pediatric Pulmonologist, University of Arkansas for Medical Sciences Children's Hospital

Gulnur Com, MD is a member of the following medical societies: American Academy of Pediatrics, American Thoracic Society, and Cystic Fibrosis Foundation

Disclosure: Nothing to disclose.

Specialty Editor Board

Glenn Fennelly, MD, MPH  Director, Division of Infectious Diseases, Lewis M Fraad Department of Pediatrics, Jacobi Medical Center; Clinical Associate Professor of Pediatrics, Albert Einstein College of Medicine

Glenn Fennelly, MD, MPH is a member of the following medical societies: Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Larry I Lutwick, MD  Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Mary E Cataletto, MD  Director of Children's Sleep Services, Winthrop Sleep Disorders Center; Professor of Clinical Pediatrics, State University of New York at Stony Brook

Mary E Cataletto, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Chest Physicians

Disclosure: Shering Plough Pharmaceuticals Honoraria Consulting

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

References

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Hilar lymphadenopathy in an 11-year-old child.
Map demonstrates the distribution of histoplasmin skin-test positivity by region. Used with permission from the American Thoracic Society.
Hematoxylin and eosin stain of infected lung tissue. Histoplasma organisms appear to have a false capsule.
Starling roost in Alabama.
Acute pulmonary syndrome in a 16-year-old female adolescent.
Fibrosing mediastinitis with mediastinal widening and tracheal deviation.
 
 
 
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