HISTOPLASMOSIS |
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DESCRIPTION
Histoplasmosis is a fungus infection confined mostly to people who live in eastern and midwestern parts of the U.S. The lungs, the central nervous system--including the brain, the coverings of the brain (meninges), and the spinal cord -- and peripheral nerves, as well as the gastrointestinal system are involved.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
Hospitalization for complications.
SIGNS & SYMPTOMS
Cough and other symptoms similar to a cold.
Loss of appetite, diarrhea, and weight loss.
Fever.
Headache.
Irritability.
Paleness.
Abdominal swelling.
Breathing difficulty (rare).
CAUSES
Infection by the fungus histoplasma capsulatum. People become infected by breathing dust that contains fungus spores. The fungus is found in soil contaminated by feces of birds and bats that carry the fungus. Contaminated soil is most often in pigeon lofts, barns, chicken houses, damp areas under bridges, along streams, and in caves.
RISK FACTORS
Recent severe illness, especially uremia, diabetes mellitus, chronic lung disease, cancer, or severe burns.
Geographic location. The disease occurs most often in the western Appalachian slopes and the Mississippi, Missouri and Ohio River valleys.
Use of immunosuppressive, anti-cancer or cortisone drugs.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should avoid areas where the soil is likely to be infected with histoplasma spores.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies, such as a sputum culture, blood studies for rising and falling titers (See Glossary), and skin tests.
POSSIBLE COMPLICATIONSSpread of infection to the child's heart, spleen, adrenal glands, and meninges (membranes that cover the brain). This is rare, but it can be fatal.
PROBABLE OUTCOME
Usually curable--even with complications -- with intensive care and 10 to 12 weeks of treatment with anti-fungal drugs. Most children only feel tired or "bad" for several weeks.
TREATMENT
HOME CARE
Isolation is not necessary. The disease is not transmitted from person to person.
Use a cool-mist humidifier with pure water and no medicine in it to increase air moisture near your child. This helps thin lung secretions so they can be coughed up more easily.
Urge your child not to smoke.
Use a heating pad on the child's chest to relieve pain.
Weigh your child daily and keep a record.
MEDICATION
Your doctor may prescribe anti-fungal drugs that must be given intravenously in a hospital.
Don't suppress the child's cough with cough medicine if it produces sputum. Coughing rids the lungs of mucus. If the cough is painful and non-productive, consult your doctor about a prescription cough suppressant.
Use acetaminophen or aspirin to relieve your child's pain.
ACTIVITY
Your child should stay in bed until the fever, pain, and shortness of breath disappear for at least 48 hours. Then normal activities can be resumed gradually. Many children are fatigued and weak after recovery. Don't expect too much too soon.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of histoplasmosis.
The following occurs during treatment:
-- Weight loss continues.
-- Fever rises to 101F (38.3C) orally.
-- Diarrhea is uncontrollable.
-- Severe headache and stiff neck begin.
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