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Post detection treatment varies on the stage and type of infection. With chronic infections that flare up after secondary immune compromise events, prolonged treatments with antifungals will occur for about a year (1) (5). Chronic infections have different styles, however treatment will stay the same for all chronic infections with any variance being on medication dosage levels (3) (6). The worse stage of chronic infection is when the yeast becomes disseminated and spreads through the blood to other organs and tissues, which is known as a systemic infection. This stage is very lethal if left untreated due to potential systemic organ failure, however treatment in patients that do not suffer irreversible damage to their tissue is extremely successful (5) (6). Subsequent medications of balancers might be utilized for later stages of this, however antifungals of the same style will be utilized. Due to the reclusive nature of the microbe in undetected stages, it remains hard to detect and subsequently treat it (6). A good reference is that in cases of greater infection, symptoms from H. capsulatum will occur which allows for detection and subsequent treatment.
A key reminder is that the elderly and adolescents pose a higher risk of acute infections due to structurally weaker immune systems. Awareness of the microbe and its symptoms can lead to proper detection and subsequent treatment of such individuals at higher risk.
Prevention of infections is a seemingly coordinated effort for H. capsulatum. Prevention of accumulated bird or bat droppings near opportune soil environments is a combined effort. Within working environments with higher risk, utilization of greater personal protective equipment (PPE) is vital to preventing potential infections. Awareness of areas containing high concentrations of bats and birds is a great advantage in the field of prevention. Contrary to land birds, aquatic birds such as gulls, provide no threat to infection. As with most infections that spike in immune-compromisation, keeping a healthy immune system is vital in preventing more harmful and serious infections (5) (7). Proper diet, sleep patterns, and proper actions within the state of being sick are crucial for preventing a weakening of the immune system. A key thing to note in this is that infections leading to sickness can weaken an immune system to the point where different subsequent microbes, such as H. capsulatum, are allowed to have a more opportune impact on a host. Proper health measures during illness, such as sleeping enough and eating well are crucial for preventing subsequent infections from other microbes (5). With acquired immune deficiency syndrome (AIDS) at pandemic levels, and fungal vaccines still in developmental stages, proper preventative measures prove highly effective for preventing such a microbe from having a high impact on the population. (1)
To summarize, H. capsulatum resides in the central US with 5 – 20% of lifetime residents obtaining chronic infections. Soil frequented by birds, bats, and livestock pose a higher risk, so be aware with frequenting these areas in the ideal temperature range (77 degrees), since any walking can release spores. Infection will occur in the lungs and can eventually progress to a systemic infection. Asymptomatic chronic infections are frequent and these are problematic if your immune system is weakened by future infections. Symptomatic infections will result fairly recent after infection and seeking of a physician is important to prevent a systemic infection. The key factor with infection of H. capsulatum is prevention of a systemic infection, which can be avoided by being aware of symptoms and seeking of medical assistance. Be aware that elderly, adolescent, and immune-compromised individuals (AIDS) are at a higher risk of infection, and observe symptoms in those individuals if they arise while encouraging seeking medical treatment. Keeping a healthy immune system through sleeping, eating, and exercising properly is a key factor in managing infections and should be done regardless.
(1) Medici, Natasha P., and Maurizio Del Poeta. "New Insights on the Development of Fungal Vaccines: From Immunity to Recent Challenges." Mem. Inst. Oswaldo Cruz MemÃ³rias Do Instituto Oswaldo Cruz 110.8 (2015): 966-73. Web.
(2) Bossche, Hugo, Frank Odds, and David Kerridge. Dimorphic Fungi in Biology and Medicine. 1st ed. New York and London: Plenum Press, 1993
(3) Chang, Ryan. "Histoplasmosis." 19 Sep 2005. emedicine. 25 Aug 2007 <http://www.emedicine.com/MED/topic1021.htm>.
(4) Heitman, Joseph, Scott G. Filler, Aaron P. Mitchell, and John E. Edwards, Jr.Molecular Principles of Fungal Pathogenesis. 1st ed. New York: ASM Press, 2006. (Heitman et al. 611-626)
(5) "Histoplasmosis." Centers for Disease Control and Prevention. 12 Oct 2005. Centers for Disease Control and Prevention. 25 Aug 2007 <http://www.cdc.gov/ncidod/dbmd/diseaseinfo/histoplasmosis_g.htm>.
(6) Kobayashi, George S.. "Molecular Basis of Adaptation in Histoplasma capsulatum ." Washington University School of Medicine. 25 Aug 2007 <http://research.medicine.wustl.edu/OCFR/Research.nsf/Abstracts/64ABA9996B650C50862567ED00029E69?OpenDocument&VW=Infectious+Diseases>.
(7) Lai, Chung-Hsu, Chun-Kai Huang, Chuen Chin, Ya-Ting Yang, and Hsiu-Fang Lin. "Indigenous Case of Disseminated Histoplasmosis, Taiwan." Emerging Infectious Diseases Jan 2007 127-129.