Treatment and Health Tips for Histoplasmosis | Spelunker’s Lung | Caver’s Disease

Treatment and Health Tips for Histoplasmosis

Treatment for Histoplasmosis is basically by antifungal medication. Mild infection and chronic low-grade illness can be treated with oral medication, but progressive disease or severe disease needs intravenous antifungals.

Acute Primary Histoplasmosis

Treatment of severe acute primary histoplasmosis is by:

• Intravenous antifungal (lipid Amphotericin B) for 2 weeks
• Followed by oral Itraconazole for 12 weeks

Cavitary Pulmonary Histoplasmosis

Cavitary Pulmonary Histoplasmosis is a chronic infection and needs oral itraconazole for 12 months.

Progressive Disseminated Histoplasmosis

Progressive Disseminated Histoplasmosis requires:

• Intravenous antifungal (lipid Amphotericin B) for 2 weeks
• Oral Itraconazole for 12 months

Central Nervous System involvement

Involvement of the CNS by histoplasmosis requires a longer course of intravenous antifungal medication

• Liposomal Amphotericin B intravenously for 4-6 weeks
• Oral Itraconazole for 12 months

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Presumed Ocular Histoplasmosis Syndrome (POHS)

Treatment for POHS is initiated if there are abnormal blood vessels growing in the retina. Even with recent advances, POHS is not a fully curable disease and patients may have recurrent episodes. The treatment options include:

• Thermal Laser
• This uses a beam of light to destroy the abnormal blood vessels, but it also destroys the overlying retina
• Photodynamic therapy
• This uses a dye injected into a vein, so that selective targeting of the new vessels can be done while sparing the retina
• Intravitreal Steroids
• Triamcinolone acetate, a steroid, has been used in POHS via direct injection into the eye
• Intravitreal Bevacizumab
• Bevacizumab is a monoclonal antibody against a substance that causes proliferation of blood vessels (VEGF)
• Surgery
• Low Vision Aids

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Treatment for underlying conditions

Treatment of any underlying condition, which could exacerbate the disease, such as AIDS, should be done. While treating AIDS, the possibility of sudden immune redevelopment causing injury, called IRIS syndrome must be kept in mind, but should not preclude the treatment for AIDS.

Health Tips

1. Consult your doctor if you have persistent cough or tiredness
2. Ask for regular eye check up
3. Use proper protective equipment like face masks if you are working in an environment that involves a lot of dust