Treatment

Diagnostic Studies And Procedures

The goal of diagnostic procedures is to differentiate histoplasmosis from other diseases. In addition to chest X-rays, studies may include skin and blood tests. Laboratory examinations of sputum, urine, bone marrow, and a liver biopsy may also be ordered.

Medical Treatments

Depending on the extent of the infection, the medication of choice is either of two antjfungal agents: ketoconazole (Nizoral), which is given by mouth, or amphotericin B (Fungizone), which is administered intravenously. If the infection has reached the central nervous system, as might happen in people who have AIDS, amphotericin B is injected into the spinal column. While the adverse side effects of ketoconazole nausea, diarrhea, abdominal pain, and itching are minor when compared with those of amphotericin B fat loss, anemia, fever, and kidney disorders both of these drugs must be monitored closely because of their potential to produce liver toxicity. Antifungal medications are not effective for treating the histoplasmosis syndrome that affects the eyes. In these instances, treatment consists of a combination of corticosteroids, laser surgery, and radiation therapy, all directed to the retina. In cases of extensive lung damage, the affected portions of the lung may be surgically removed.