Pulmonary complications of histoplasmosis

Histoplasmosis is one of the most common endemic mycoses in the United States, caused by the organism Histoplasma Capsulatum. The classic type is characterized by pulmonary disease. The African type, on the other hand, has extrapulmonary manifestations such as ulcers and bone lesions. Histoplasma first enters the body of a human host as conidia inhaled from the soil into the bronchioles and alveoli. When alveolar macrophages invade the yeasts, the inhaled conidia convert into yeast in the body, resulting in the pathogenesis of Histoplasmosis. Histoplasma can infect skin, bones, lymph nodes, spleen, muscles, liver, oral cavity, and mucosa, but it primarily affects the pulmonary system. Early Histoplasmosis diagnosis is lifesaving because it allows for prompt treatment and reduces the risk of serious complications. Histopathology, culture, and cytology are common Histoplasma diagnostic tests. Isolation of the intracellular form of the yeast on culture is the gold standard test for Histoplasma. The symptoms include dyspnea, a nonproductive cough, chest pain, and diffuse lung involvement. Extrapulmonary symptoms include fever, chills, malaise, hepatosplenomegaly, lymphadenopathy, bone marrow suppression (pancytopenia), and elevated liver function tests. According to current practice guidelines, the management of Histoplasmosis should be based on the specific clinical manifestations and severity. In all cases, the two most used antifungal agents are azoles and amphotericin B. Furthermore, for those who are unable to tolerate first-line agents, the relatively limited research availability on second and third-line agents becomes a significant barrier.