Treatment:

The main treatment for histoplasmosis is antifungal drugs. Amphotericin B, itraconazole, and ketoconazole are the usual treatments.

Antifungals may be given through a vein, depending on the form or stage of disease.

In some cases, long-term treatment with antifungal drugs may be needed.

Expectations (prognosis):

What happens depends on the extent of the infection and the overall health of the individual. The death rate is fairly high for people with untreated widespread (disseminated) histoplasmosis, but is reduced significantly with treatment.

Complications:

• Fibrosing mediastinitis -- scarring in the chest that may entrap the following body parts:
  • The major blood vessels carrying blood to and from the heart
  • Esophagus (food pipe)
  • Heart
  • Lymph nodes
• Inflammatory syndromes involving:
  • Heart lining (pericarditis)
  • Joints (arthritis)
  • Rashes (erythema nodosum, erythema multiforme)
  • Skin nodules
• Mediastinal granuloma -- enlarged chest-cavity lymph nodes, which may compress body parts such as the esophagus and blood vessels of the lungs
• Medication side effects (for example, amphotericin can have severe side effects)

In addition, people who have a weakened immune system may develop disseminated disease, which can infect the meninges of the brain (causing meningitis).

Calling your health care provider:

Notify your health care provider if you live in an area where histoplasmosis is common, and you develop flu-like symptoms, chest pain, cough and shortness of breath. While there are many other illnesses that have similar symptoms, you may need to be tested for the possibility of histoplasmosis.