IDS Fungal Histoplasmosis Flashcards
Endemic regions for histoplasmosis (3)
MOL
Mississipi River valleys
Ohio
Latin America
Risk factors for histoplasmosis (3)
environmental exposure
(+) histoplasma serology
CD4 <150 cells/uL
presents as asymptomatic/mild disease
a. acute pulmonary histoplasmosis
b. cavitary pulmonary histoplasmosis
c. disseminated histoplasmosis
d. more than 1 answer
A
fever, wt. loss
a. acute pulmonary histoplasmosis
b. cavitary pulmonary histoplasmosis
c. disseminated histoplasmosis
d. more than 1 answer
D; b and c
fever, wt loss cough chest pain dyspnea
a. acute pulmonary histoplasmosis
b. cavitary pulmonary histoplasmosis
c. disseminated histoplasmosis
B
fever wt loss hepatosplenomegaly hematologic disturbance
a. acute pulmonary histoplasmosis
b. cavitary pulmonary histoplasmosis
c. disseminated histoplasmosis
C
caseating and noncaseating granuloma, few yeast, giant cells
a. acute pulmonary histoplasmosis
b. cavitary pulmonary histoplasmosis
c. disseminated histoplasmosis
A
diffuse macrophage proliferation, abundant giant cells
a. acute pulmonary histoplasmosis
b. cavitary pulmonary histoplasmosis
c. disseminated histoplasmosis
C
noncaseating granuloma, interstitial fibrosis necrosis, yeast, cavities
a. acute pulmonary histoplasmosis
b. cavitary pulmonary histoplasmosis
c. disseminated histoplasmosis
B
Treatment for acute pulmonary moderate to severe histpolasmosis with diffuse infiltrates and or hypoxemia
Lipid AmB 3-5 mg/kg/d +- glucocorticoids for 1-2 weeks then itraconazole 200 mg bid for 12 weeks
monitor renal and hepatic function
Treatment for chronic/cavitary pulmonary histoplasmosis
itraconazole 200 mg qd or bid for at least 12 mos.
monitor hepatic function
Progressive disseminated histoplasmosis treatment
Lipid AmB 3-5 mg/kg/day for 1-2 wks then itraconazole 200 mg bid for at least 12 months
Central nervous system involvemen histoplasmosis treatment
liposomal AmB 5mkd for 4-6 wks then itraconazole 200 mg bid for at least 12 mos monitor renal and hepatic function
