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Histaplasmosis Treatment Options

February 8, 2010 - 9:08pm 243 reads 0 comments

Like in the cases of Coccidioimycosis and Mucormycosis, the anti-fungal drug Amphotericin B is used in its intravenous form and is followed by oral administration of Itraconazole or ketoconazole. The duration for which the drugs need to be taken depends entirely on the intensity, spread and organ(s) affecting the patient.

Chronic Pulmonary Histoplasmosis patients are prescribed Itraconazole for an year if pulmonary cavity shows lesions in imaging results. At the end of multiple doses, if the lesions continue, surgical options are considered.

Lesions of the Cutaneous and Rheumatologic Histoplasmosis types are generally self-limiting or recessive.

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Progressive Disseminated Histoplasmosis – the most deadly of the forms of Histoplasmosis requires immediate thoracentesis (an invasive procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes) and pericardiocentesis as well as pericardial tamponade, if required.

Histoplasmosis affecting the eyes calls for extensive maculopathy using steroids.
Fluconazole, Voriconazole, are also prescribed by doctors as an alternative to the usual anti-fungal drugs. Dosages and potencies as well as duration are all recommended by the physician on a case by case basis. NSAIDs like Ibuprofen, Corticosteroids like Prednisome are sometimes advised to manage symptomatic problems.

Despite the aggressive route of treatment sometimes complications occur either before the treatment commences or during the initial stages of the therapy. They may include infection of the meninges of the brain, fibrosing mediastinitis (scarring affecting the heart muscles, lymph nodes and windpipe), inflammatory syndromes of the heart lining, joints and skin nodules, medication side effects, and mediastinal granuloma (enlarging of the chest cavity causing the other organs to be pressed due to the swelling). In rare cases, pleural effusions and kidney malfunctions are also reported.
Prevention of the Ohio River Valley Fever or Darling’s Disease is simply to minimise contact with potentially contaminated environments like bird habitats and educating the people about the disease.

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