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], Usama Talib, BSc, MD [3], Aravind Kuchkuntla, M.B.B.S[4]

Overview

Histoplasmosis can be classified with respect to the involved organ system. This can include pulmonary, nervous system, cardiovascular system and mediastinum. Histoplasmosis can also be classified according to the severity in to mild, moderate and severe, according to disease duration into acute, subacute, chronic and recurrent and according to the progression of the disease into localized or disseminated histoplasmosis.[1][2]

Classification

A. Organ system classification

  • 1. Pulmonary histoplasmosis
  • This may manifest in the following forms:
  • 2. CNS histoplasmosis
  • 3. Histoplasma pericarditis
  • 4. Rheumatologic histoplasmosis
  • 5. Mediastinal histoplasmosis

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

D. Progression of disease


References

  1. Untanu RV, Akbar S, Graziano S, Vajpayee N (2016). "Histoplasmosis-Induced Hemophagocytic Lymphohistiocytosis in an Adult Patient: A Case Report and Review of the Literature". Case Rep Infect Dis. 2016: 1358742. doi:10.1155/2016/1358742. PMC 5088313. PMID 27830097.
  2. Wheat LJ, Azar MM, Bahr NC, Spec A, Relich RF, Hage C (2016). "Histoplasmosis". Infect Dis Clin North Am. 30 (1): 207–27. doi:10.1016/j.idc.2015.10.009. PMID 26897068.