Histoplasmosis history and symptoms: Difference between revisions

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*Anorexia
*Anorexia
*Unintentional weight loss
*Unintentional weight loss
===Acute Pulmonary Histoplasmosis===
It is an acute self limiting illness in patients exposed to the organism for the first time. The symptoms of an acute infection include the following:
*A positive history for exposure to H.capsulatum and close contacts with similar complaints is hellpful to diagnose pulmonary histoplasmosis.
*Fever
*Malaise
*Headache
*Weakness
*Substernal chest discomfort
*Dry cough
*Myalgias and arthralgias with symmetrical joint involvement
===Chronic Cavitatory Pulmonary Histoplasmosis===
It is usually seen in elderly patients with emphysema and these patients present with the following symptoms:
*Fatigue
*Fever
*Night sweats
*Anorexia and weight loss
*Cough,
*Sputum production
*Hemoptysis
*Dyspnea
===Granulomatous Mediastinitis===
Majority of patients with mediastinal lymph node involvement are asymptomatic but few patients present with symptoms resulting from compression on the esophagus, superior vena cava and bronchus:
*Dysphagia
*Congestion of the face
*Distended veins in the neck
*Dyspnea
===Mediastinal Fibrosis===
It is a complication of histoplasma infection of the mediastinal structures resulting in fibrosis and causing compression of surrounding structures in the mediastinum. The symptoms of fibrosis include the following:
*It is seen in patients between the ages of 20 to 40 years of age.
*It follows a gradual progression of symptoms with compression of the superior vena cava, the pulmonary arteries, pulmomary veins, bronchi, thoracic duct, recurrent laryngeal nerve, and right atrium.
*Patients present with increasing dyspnea, cough, hemoptysis, and chest pain.
*Superior vena cava compression presents with features of distended neck veins and facial congestion.
*Right heart failure presents with pedal edema and dyspnea.
===Brocholithiasis===
In patients with calcified nodules bursting into the bronchus present with features of brochial obstruction and inflammation. The features include the following:
*Lithoptysis: Spitting of tiny pieces of gravel like particles
*Dyspnea
*Hemoptysis
*Cough
*Occasional wheezing can be present with significant airway obstruction


==References==
==References==

Revision as of 17:54, 2 May 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Symptoms

Acute Disease Symptoms

  • The incubation period of histoplasmosis is typically 3–17 days for the acute disease.
  • The vast majority of infections are asymptomatic or result in a mild influenza-like illness.
  • More manifest disease is characterized by:
  • Headache
  • Nonproductive cough
  • Chills
  • Weakness
  • Pleuritic chest pain
  • Fatigue
  • Most people spontaneously recover 2–3 weeks after onset of symptoms, although fatigue may persist longer.
  • Dissemination, especially to the gastrointestinal tract and central nervous system, can occur in people who are immunocompromised.[1]

Chronic Disease Symptoms

Chronic pulmonary histoplasmosis is characterized by:[2]

  • Chronic productive cough
  • Excessive fatigue
  • Anorexia
  • Unintentional weight loss

Acute Pulmonary Histoplasmosis

It is an acute self limiting illness in patients exposed to the organism for the first time. The symptoms of an acute infection include the following:

  • A positive history for exposure to H.capsulatum and close contacts with similar complaints is hellpful to diagnose pulmonary histoplasmosis.
  • Fever
  • Malaise
  • Headache
  • Weakness
  • Substernal chest discomfort
  • Dry cough
  • Myalgias and arthralgias with symmetrical joint involvement

Chronic Cavitatory Pulmonary Histoplasmosis

It is usually seen in elderly patients with emphysema and these patients present with the following symptoms:

  • Fatigue
  • Fever
  • Night sweats
  • Anorexia and weight loss
  • Cough,
  • Sputum production
  • Hemoptysis
  • Dyspnea

Granulomatous Mediastinitis

Majority of patients with mediastinal lymph node involvement are asymptomatic but few patients present with symptoms resulting from compression on the esophagus, superior vena cava and bronchus:

  • Dysphagia
  • Congestion of the face
  • Distended veins in the neck
  • Dyspnea

Mediastinal Fibrosis

It is a complication of histoplasma infection of the mediastinal structures resulting in fibrosis and causing compression of surrounding structures in the mediastinum. The symptoms of fibrosis include the following:

  • It is seen in patients between the ages of 20 to 40 years of age.
  • It follows a gradual progression of symptoms with compression of the superior vena cava, the pulmonary arteries, pulmomary veins, bronchi, thoracic duct, recurrent laryngeal nerve, and right atrium.
  • Patients present with increasing dyspnea, cough, hemoptysis, and chest pain.
  • Superior vena cava compression presents with features of distended neck veins and facial congestion.
  • Right heart failure presents with pedal edema and dyspnea.

Brocholithiasis

In patients with calcified nodules bursting into the bronchus present with features of brochial obstruction and inflammation. The features include the following:

  • Lithoptysis: Spitting of tiny pieces of gravel like particles
  • Dyspnea
  • Hemoptysis
  • Cough
  • Occasional wheezing can be present with significant airway obstruction

References

  1. Chiller, TM. Chapter 3 Infectious Diseases Related to Travel. Histoplasmosis. Available at: http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/histoplasmosis. Accessed February 2, 2016.
  2. Goodwin RA, Owens FT, Snell JD, Hubbard WW, Buchanan RD, Terry RT; et al. (1976). "Chronic pulmonary histoplasmosis". Medicine (Baltimore). 55 (6): 413–52. PMID 792626.