Histoplasmosis is a common endemic mycosis that is usually asymptomatic but occasionally results in severe illness. Histoplasmosis and its causative agent, Histoplasma capsulatum, are found worldwide but particularly in North and Central America. Within the United States, infection is most common in the midwestern states located in the Ohio and Mississippi River valleys. Among the endemic mycoses, it is the most common cause for hospitalization .
The diagnosis and treatment of the various histoplasmosis pulmonary syndromes will be reviewed here. The pathogenesis and clinical features of these syndromes and issues regarding histoplasmosis in HIV-infected patients are discussed separately. (See "Pathogenesis and clinical features of pulmonary histoplasmosis" and "Diagnosis and treatment of histoplasmosis in HIV-infected patients".)
WHEN TO SUSPECT HISTOPLASMOSIS
Pulmonary histoplasmosis should be considered in patients with the following clinical presentations, particularly in the appropriate epidemiologic setting:
●Pneumonia with mediastinal or hilar lymphadenopathy
●Mediastinal or hilar masses