Like in the cases of Coccidioimycosis and Mucormycosis, the anti-fungal drug Amphotericin B is used in its intravenous form and is followed by oral administration of Itraconazole or ketoconazole. The duration for which the drugs need to be taken depends entirely on the intensity, spread and organ(s) affecting the patient.
Chronic Pulmonary Histoplasmosis patients are prescribed Itraconazole for an year if pulmonary cavity shows lesions in imaging results. At the end of multiple doses, if the lesions continue, surgical options are considered.
Lesions of the Cutaneous and Rheumatologic Histoplasmosis types are generally self-limiting or recessive.
Progressive Disseminated Histoplasmosis – the most deadly of the forms of Histoplasmosis requires immediate thoracentesis (an invasive procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes) and pericardiocentesis as well as pericardial tamponade, if required.
Histoplasmosis affecting the eyes calls for extensive maculopathy using steroids.
Fluconazole, Voriconazole, are also prescribed by doctors as an alternative to the usual anti-fungal drugs. Dosages and potencies as well as duration are all recommended by the physician on a case by case basis. NSAIDs like Ibuprofen, Corticosteroids like Prednisome are sometimes advised to manage symptomatic problems.
Despite the aggressive route of treatment sometimes complications occur either before the treatment commences or during the initial stages of the therapy. They may include infection of the meninges of the brain, fibrosing mediastinitis (scarring affecting the heart muscles, lymph nodes and windpipe), inflammatory syndromes of the heart lining, joints and skin nodules, medication side effects, and mediastinal granuloma (enlarging of the chest cavity causing the other organs to be pressed due to the swelling). In rare cases, pleural effusions and kidney malfunctions are also reported.
Prevention of the Ohio River Valley Fever or Darling’s Disease is simply to minimise contact with potentially contaminated environments like bird habitats and educating the people about the disease.
Other measures are reactionary such as spraying fungal disinfectants over contaminated soil and wearing masks in case of outbreaks.
Outlook for Histoplasmosis patients is good for cases of acute pulmonary Histoplasmosis, however, it is bleak for progressive disseminated cases. Such cases require life-long anti-fungal maintenance dosage and relapse chances are high. Untreated sub-acute Histoplasmosis is observed to cause death in a few months. Meningal Histoplasmosis has a 50 percent fatality rate.
During treatment, all surgical procedures to avert the further spread of progressive disseminative type, involving the thorax, heart and eye, require the following observances which without, serious and undesirable results will occur. It is important that a patient diagnosed with Histoplasmosis check with their doctor on surgical care details and post-operative precautions.
Mamta Singh is a published author (Migraines for the Informed Woman – Tips from a Sufferer. Publisher: Rupa & Co.), seasoned business, creative and academic writer. She is a certified fitness instructor, personal trainer & sports nutritionist through IFA, Florida USA. She is the lead writer and holds Expert Author status in many well-received health, fitness and nutrition sites. Mamta runs her own popular blogs on migraines in women and holistic health. Mamta holds a double Master's Degree in Commerce and Business, and is presently training as a Holistic Healing Therapist from the U.K. She is a registered practitioner with the UN recognised Art of Living Foundation.
Link: http://www.migrainingjenny.wordpress.com and http://www.footstrike.wordpress.com
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