RT Book, Section
A1 Raffanti, Stephen P.
A1 Person, Anna K.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181057398
T1 Histoplasmosis
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181057398
RD 2024/09/19
AB Disseminated  histoplasmosis  most  commonly  occurs  in  immunocompromised  patients  living  in  the  Ohio  and  Mississippi  River  Valleys.  HIV-infected  patients  with  disseminated  histoplasmosis  usually  have  a  CD4  count  <200  cells/mm3  and  present  with  fever,  weight  loss,  malaise,  and  pulmonary  symptoms  such  as  cough  and  dyspnea.  Pulmonary  symptoms  predominate,  and  in  severe  cases,  patients  may  present  with  acute  respiratory  distress  syndrome.  Patients  may  present  with  a  diffuse  papular  rash  in  disseminated  disease.  Mediastinitis  is  a  rare  but  serious  complication  of  histoplasmosis.  Urine  and  serum  antigen  testing  carries  a  high  sensitivity,  but  bronchoalveolar  lavage  may  be  needed  to  make  the  diagnosis  in  cases  of  pulmonary  involvement.  Serum  LDH  and  alkaline  phosphatase  levels  may  be  markedly  elevated  as  well.