Histoplasmosis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]

Overview

Classification

A. Organ system classification

  • 1. Pulmonary histoplasmosis
  • This may manifest in the following forms
    • Acute pulmonary histoplasmosis
    • Chronic cavitary pulmonary histoplasmosis
    • Broncholithiasis
    • Pulmonary Nodules (Histoplasmomas)
  • 2. CNS histoplasmosis
  • 3. Histoplasma pericarditis
  • 4. Rheumatologic histoplasmosis
  • 5. Mediastinal histoplasmosis
  • This may manifest in the following forms.
    • Mediastinal lymphadenitis
    • Mediastinal granuloma
    • Mediastinal fibrosis

B. Severity of disease

On the basis of disease severity, histoplasmosis may be as follows:

According to severity of the disease
Mild
  • Early diagnosis and treatment
  • Responds to medical treatment
  • Typical clinical presentation
  • Good prognosis
Moderate
  • May present late with typical or atypical symptoms
  • May present with complications
  • Variable response to treatment
Severe
  • Presents with complications or prolonged illness
  • Immunocompromised
  • Common in extremes of age
  • Delayed diagnosis and treatment
  • Surgical treatment may be required in addition to medical treatment
  • Increased morbidity and mortality

C. According to the duration of disease

According to the duration of disease
Acute
  • Lasts few weeks
  • Patient acutely ill
  • Mostly in HIV-associated patients
  • Impaired consciousness
  • Seeks medical treatment early due to sudden deterioration
Subacute
  • Lasts less than 4 weeks
  • Patient acutely ill
  • Mostly in HIV-associated patients
  • Impaired consciousness
  • Seeks medical treatment early due to sudden deterioration
Chronic
  • Lasts more than 4 weeks
  • Gradual deterioration of patient
  • Prolonged history of atypical symptoms
  • Common in older patients
Recurrent
  • Multiple episodes which lasts less than 4 weeks
  • History of incompliance to medication
  • immunosuppression may be the underlying cause

References