Histoplasmosis physical examination
Histoplasmosis physical examination On the Web
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Editor-In-Chief: C. Michael Gibson, M.S., M.D.  Associate Editor(s)-in-Chief: Serge Korjian M.D., Aravind Kuchkuntla, M.B.B.S
Physical examination findings in pulmonary histoplasmosis include erythema nodosum and rales on auscultation. In patients with disseminated histoplasmosis features similar to sepsis such as hypotension, altered mental status will be present.
Physical examination findings vary in patients with histoplasma infection and it depends on stage of the disease and extent of the spread of infection.
Patients with acute or chronic pulmonary histoplasmosis present with features similar to pneumonia.
 The following physical examination findings can be demonstrated:
Patient will appear ill with fever and dyspnea.
In patients with acute or chronic pulmonary histoplasmosis occasional wheezing and rales are a common finding.
- Increased tactile fremitus
- Dullness on percussion
- Decreased breath sounds
- Bronchial breath sounds
- Crackles, Rales
- Increased vocal fremitus
Patients with disseminated histoplasma infection have similar features as sepsis. The following physical examination findings can be demonstrated in a patient with disseminated infection:
Sepsis is considered present if infection is highly suspected or proven and two or more of the following systemic inflammatory response syndrome (SIRS) criteria are met:
- Heart rate > 90 beats per minute
- Temperature < 36 (96.8 °F) or > 38 °C (100.4 °F)
- Tachypnea > 20 breaths per minute or, on blood gas, a PaCO2 < 32 mm Hg
- Cervical Lymphadenopathy
- Decreased peripheral pulses
Interior view of an elderly man’s oral cavity. A histoplasmosis infection induced inflammatory response on right inferior gingival tissues. From Public Health Image Library (PHIL). 
This image depicts the perianal region of a male patient afflicted with a disease known as histoplasmosis, which is caused by the fungal organism, Histoplasma capsulatum. From Public Health Image Library (PHIL). 
This image depicts an intraoral view, which reveals a lesion of the patient’s maxillary gingival mucosa that had been diagnosed as histoplasmosis, caused by the fungal pathogen, Histoplasma capsulatum. From Public Health Image Library (PHIL). 
- ↑ Knox KS, Hage CA (2010). "Histoplasmosis". Proc Am Thorac Soc. 7 (3): 169–72. doi:10.1513/pats.200907-069AL. PMID 20463244.
- ↑ Kauffman CA (2009). "Histoplasmosis". Clin Chest Med. 30 (2): 217–25, v. doi:10.1016/j.ccm.2009.02.002. PMID 19375629.
- ↑ Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL (2008). "Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008". Critical Care Medicine. 36 (1): 296–327. doi:10.1097/01.CCM.0000298158.12101.41. PMID 18158437. Retrieved 2012-09-16. Unknown parameter
- ↑ Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. PMID 1303622.
- ↑ 5.0 5.1 5.2 "Public Health Image Library (PHIL)".