Histoplasmosis

Histoplasmosis (or reticuloendothelial Zytomykose ) is a systemic infectious disease caused by infection with the fungus Histoplasma capsulatum. In the majority of cases only or mainly the lung is affected. According to the occurrence of the pathogen histoplasmosis in South, Central and parts of North America, Indonesia and Africa is widespread. Cases in Western Europe are the exception.

Pathology

The infection with the fungus living in the soil occurs via inhalation of spores. In the lungs, these are phagocytosed by macrophages. They develop within the macrophage to yeast form, which reproduces by budding. It comes to the formation of small, first epitheloidzelliger granulomas, which have later partly centrally a " caseous " necrosis. Healing occurs with calcification. About the bloodstream histoplasmas can be abducted and attacked secondary lymph nodes, liver and spleen. Especially the reticuloendothelial system is involved in the attack.

Clinic

Most infections are silent, ie they are not noticed by the patients. Crucial to any symptoms, the infection dose and the immune status of the host. After an incubation period 3-17 days they can manifest as malaise, fever and dry cough. In AIDS patients and immunocompromised patients Histoplasmosen are frequently and be more severe. Here we may severe disseminated (widely distributed), ulcerated tissue damage. Even deaths are described.

A treatment is considered necessary only in severe disseminated gradients and performed intravenously with amphotericin B.

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