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Histoplasmosis

Последний просмотренный: 2 Aug 2025
Last updated: 19 Aug 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • exposure to fungal spores
  • risk factors that impair host defenses
  • fever
  • headache
  • dyspnea
  • dry or nonproductive cough
  • pleuritic chest pain
  • anorexia
  • productive cough
Полная информация

Другие диагностические факторы

  • abdominal pain
  • fatigue
  • malaise
  • arthralgias
  • weight loss
  • hepatosplenomegaly
  • scattered crackles on chest auscultation
  • bronchial breathing on chest auscultation
  • distant breath sounds on chest auscultation
  • hemoptysis
  • meningitis-like symptoms
  • skin lesions
  • gastrointestinal symptoms
  • sepsis-like syndrome
Полная информация

Факторы риска

  • exposure to fungus
  • emphysema
  • HIV infection
  • treatment with tumor necrosis factor (TNF)-alpha antagonists
  • treatment with corticosteroids
  • treatment with immunosuppressants
  • neutropenia
  • stem cell and solid organ transplant
  • graft-versus-host disease
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • chest x-ray
  • culture
  • antigen testing
  • serology (immunodiffusion precipitin test)
  • serology (complement fixation assay)
  • serology (enzyme immunoassay)
  • CT scan of chest
  • CBC
  • LFTs
Полная информация

Исследования, проведение которых нужно рассмотреть

  • tissue biopsy
Полная информация

Алгоритм лечения

Острый

latent asymptomatic disease (nonpregnant)

acute pulmonary disease (nonpregnant)

chronic pulmonary disease (nonpregnant)

disseminated disease (nonpregnant)

mediastinal granuloma (nonpregnant)

mediastinal fibrosis (nonpregnant)

broncholithiasis (nonpregnant)

pericarditis (nonpregnant)

rheumatologic syndrome (nonpregnant)

meningoencephalitis (nonpregnant)

pregnant

Составители

Авторы

Zainab A. Malik, MD, MS, FAAP

Consultant

Pediatrics and Pediatric Infectious Diseases

Mediclinic City Hospital

Dubai

United Arab Emirates

Раскрытие информации

ZAM has received speakers' honoraria from Merck-MSD.

David L. Goldman, MD

Associate Professor

Pediatric Infectious Diseases

The Children's Hospital at Montefiore

New York

NY

Раскрытие информации

DLG declares that he has no competing interests.

Рецензенты

Kassem Hammoud, MD

Associate Professor

Division of Infectious Diseases

University of Kansas Health System

Kansas City

MI

Раскрытие информации

KH declares that he has no competing interests.

Adriana M. Rauseo, MD

Assistant Professor of Medicine

Division of Infectious Diseases

Department of Internal Medicine

Washington University in St Louis

St Louis

MI

Раскрытие информации

AMR declares that she has no competing interests.

Paul Roberts, MD

Assistant Professor

Family Medicine

Mayo Clinic

Jacksonville

FL

Раскрытие информации

PR declares that he has no competing interests.

Janak Koirala, MD

Associate Professor of Medicine

Division of Infectious Diseases

Department of Internal Medicine

Southern Illinois University School of Medicine

Springfield

IL

Раскрытие информации

JK declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Wheat LJ, Freifeld AG, Kleiman MB, et al. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis. 2007 Oct 1;45(7):807-25.Полный текст  Аннотация

Thompson GR 3rd, Le T, Chindamporn A, et al. Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology. Lancet Infect Dis. 2021 Dec;21(12):e364-74.Полный текст  Аннотация

National Institutes of Health, Centers for Disease Control and Prevention, HIV Medicine Association, and the Infectious Diseases Society of America. Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: histoplasmosis. Oct 2024 [internet publication].Полный текст

Hage CA, Carmona EM, Epelbaum O, et al. Microbiological laboratory testing in the diagnosis of fungal infections in pulmonary and critical care practice. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2019 Sep 1;200(5):535-50.Полный текст  Аннотация

Статьи, указанные как источники

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