Histoplasmosis? Five More Questions For Your Doctor

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If you have been diagnosed with histoplasmosis, here are five more questions you may wish to ask your doctor:

1. You have run the sputum test for me and taken the blood antigen test. Will I need to go through any more testing?
That depends upon your doctor. If he or she considers it necessary to conduct a differential diagnosis, then they may prescribe any of the following or a combination of one or more of the following tests to be run on you:
• Conducting an antigen test on urine, cerebro-spinal fluid, etc., using the ELISA or PCR methods.

• Samples taken from blood and tissues of other infected parts such as lymph nodes, mouth ulcers, etc., are also used to check presence of antigens through cultures.
• X-rays and CAT scan imaging will also exhibit lung condition.
• Techniques of differential diagnosis are pursued to rule out other similar conditions caused by fungus or even flu. Diseases such as blastomycosis, various types of pneumonia, lung cancer, lymphoma, aspergillosis, tuberculosis, etc., are ruled out.
• For rare types of histoplasmosis, specialists in infectious diseases are required to arrive at the correct diagnosis.
• Bronchoscopy is done only if the results of the fungal culture tests are inconclusive. Here the trachea is examined along with the bronchial passage with an endoscope and a biopsy of a tissue is taken with the endoscope.
• A complete blood count, or CBC, with differentials is recommended to be carried out.
• Tests to indicate alkaline phosphatise concentration as well as lactase dehydrogenase will be conducted.
• Titer or concentration tests for antibodies as well as immunoprecipitating tests are conducted to see which antibodies are involved with which antigens and their binding is studied.
• A pulmonary function test could also be ordered to evaluate the degree of obstruction, defect, etc.

2. Will I have to go any invasive procedure now that I am diagnosed with chronic pulmonary histoplasmosis?
Generally, 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.

3. What will be the line of treatment prescribed for me?
That depends on the type of histoplasmosis you have been diagnosed with. In general however, 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) affected for the patient.

Lesions of the cutaneous and rheumatologic histoplasmosis types are generally self-limiting or recessive.

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 and/or 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 or corticosteroids like prednisone, etc., are sometimes advised to manage symptomatic problems.

4. Are there any prevention tips for histoplasmosis?
Prevention of the Ohio River valley fever or Darling’s disease is simply to minimize contact with potentially contaminated environments like bird habitats and educating the people about the disease. Other measures are reactionary such as spraying fungal disinfectants over contaminated soil and wearing masks in case of outbreaks.

5. What is the outlook or prognosis for patients of histoplasmosis?

Outlook for histoplasmosis patients is good for cases of acute pulmonary histoplasmosis. However, it is bleak for progressive disseminated cases. Such cases require life-long anti-fungal maintenance dosage and the relapse chances are high. Untreated sub-acute histoplasmosis is observed to cause death in a few months’ times. Meningal histoplasmosis has a 50 percent fatality rate.

ALL INFORMATION GIVEN IN THIS ADVOCACY SHEET IS TO BE CHECKED WITH YOUR DOCTOR BEFORE IMPLEMENTING THEM OR TAKING THEM AS STANDARD OR VERIFIED.

Mamta Singh is a published author of the books Migraines for the Informed Woman (Publisher: Rupa & Co.) and the upcoming Rev Up Your Life! (Publisher: Hay House India). She is also a seasoned business, creative and academic writer. She is a certified fitness instructor, personal trainer & sports nutritionist through IFA, Florida USA. Mamta is an NCFE-certified Holistic Health Therapist SAC Dip U.K. She is the lead writer and holds Expert Author status in many well-received health, fitness and nutrition sites. She runs her own popular blogs on migraines in women and holistic health. Mamta holds a double Master's Degree in Commerce and Business. She is a registered practitioner with the UN recognised Art of Living Foundation. Link: http://www.migrainingjenny.wordpress.com and http://www.footstrike.wordpress.com

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