Histoplasmosis - what is it? Histoplasmosis: symptoms, diagnosis, treatment

Infectious, in particular, fungal diseases - is by no means a rarity in the modern world. With such problems people are faced regardless of age, gender and other factors. And quite dangerous is a disease called histoplasmosis.

What it is? What symptoms are accompanied? What complications can lead to? What methods of treatment does modern medicine offer? Answers to these questions will be of interest to many readers. After all, it's not a secret for anyone that almost any disease is much easier to treat in the early stages.

Histoplasmosis: what is it?

In many countries, patients face such a diagnosis. So what is a histoplasmosis? Immediately it is worth saying that this is a fungal disease, in which the pathogen affects mononuclear phagocytes, affecting the work of the immune system. This ailment in medicine is also known by the terms "reticuloendothelial cytoplasmosis" and "Darling's disease".

It should be noted that this disease has a very clear geographical distribution. In Central and South America, as well as in the southwestern regions of the United States, infection is recorded quite often. Also, the disease occurs in Southeast Asia and Africa. But on the territory of Canada, Russia and European countries, this disease is considered quite rare - such cases are recorded most often among tourists who have spent a long time in countries at risk. Despite such an insignificant spread of the disease in Russia, it will be useful for each reader to find out exactly what histoplasmosis is. Symptoms, ways of transmission, forms and features of the course of the disease are important points that will help to suspect that something is wrong and call the doctor in time.

According to statistics, among men this disease occurs twice as often. In addition, children and people with weakened immune system are more inclined to it (in pediatrics there are twice as many cases of this ailment).

Description of agent and mechanism of transmission

In order to understand what is histoplasmosis, you first need to know more about its pathogen. He is a dimorphic fungus Histoplasma capsulatum. Its tissue form is a small, unicellular organism of pear-shaped or round shape. The dimensions do not exceed 2-4 microns. A characteristic difference of this form is its intracellular location - as a rule, fungi penetrate into macrophages, spleen cells, liver, lymph nodes, etc. Histoplasmosis is a disease that primarily affects the structure of the immune system.

It is worth noting that these microorganisms are not too resistant to the external environment, nevertheless, in the presence of humidity and the appropriate temperature can maintain the ability to live. Warming up to 55-60 degrees for 45 minutes leads to death of cell cultures. But to the effects of chloramine, phenol, formalin, fungi are more stable - their dying begins 15-30 minutes after the beginning of the exposure.

A natural reservoir of these fungi is soil, which is contaminated with feces and droppings of infected animals (these can be pigeons, dogs, cats, chickens). For example, abandoned buildings, caves, wells and even air conditioners create excellent conditions for the life of these microorganisms. As a rule, infection occurs by air, when a person inhales dust with fungi. Groups of risk include construction workers, miners, farmers, tourists, geologists, speleologists, etc. Direct transmission in contact with an infected person or animal is not observed.

Getting into the human respiratory tract, fungal microorganisms acquire a tissue form, as a result of which lung damage as well as regional lymph nodes are observed. Further spread of pathogens together with blood flow leads to sensitization of the body, the production of specific antigens, and then to the defeat of other organs (not observed in all patients).

The main forms of the disease

Immediately it is worth saying that there are several forms in which histoplasmosis can manifest. What is it and what are the features and differences of these varieties of the disease?

For example, depending on the course, an acute and chronic form of the disease is isolated. With acute histoplasmosis, symptoms appear abruptly, the ailment develops rapidly. Chronic disease, on the other hand, is lethargic, but often leads to irreversible changes in tissues.

Most often, the infection affects the respiratory system, resulting in the development of histoplasmosis of the lungs. Nevertheless, extrapulmonary forms are also possible. Particularly dangerous is the desensitized histoplasmosis - it is a form of a disease that affects mucous tissues, skin, internal organs and leads to various complications, including arthritis, encephalitis, cardiovascular system disorders, etc.

Acute histoplasmosis of the lung: symptoms

As mentioned earlier, fungal pathogens penetrate the human body together with inhaled dust. That's why the most common is pulmonary histoplasmosis. Symptoms of it largely depend on the state of the patient's immune system.

The incubation period ranges from 4 to 30 days, although activation usually occurs 7-14 days after inhalation of pathogenic fungi. In most people, the disease is mild, without causing any serious disturbances. Quite often, patients do not even know about their illness. Histoplasmosis can be accompanied by a small cough, runny nose and a short-term rise in temperature. Symptoms go away after a few days, so they are often confused with a common cold.

However, some patients are diagnosed with severe histoplasmosis. What it is? This form of the disease is accompanied by more severe disorders. First there is a fever (often body temperature rises to 41 degrees), as well as some other symptoms of intoxication, including nausea, vomiting, diarrhea. The patient complains of severe sweating, which alternates with a strong chill. There is weakness, severe headaches, coughing with sputum, whose attacks are often accompanied by pain in the chest. Symptoms of the disease include arthralgia.

After a few days (sometimes even weeks), the fever passes, but the subfertinal body temperature keeps. Patients in this period complain of severe weakness and fatigue, loss of appetite, a sharp decrease in body weight.

Chronic form of the disease

In the absence of treatment or improperly administered therapy, chronic histoplasmosis sometimes develops in patients. Symptoms of this disease are most often greased. From time to time, patients develop a small fever, which, however, quickly passes by itself. In addition, the symptoms of the disease can be attributed to a persistent cough, which is often accompanied by sputum, and also causes breathing problems.

There are some very serious complications, which can lead to chronic histoplasmosis. The X-ray photo presented above demonstrates that with time, lung tissue changes. To begin with in the foci of inflammation, infiltrates are formed, which can disappear or turn into fibrosis. Also this form of the disease is fraught with the formation of calcifications in the lung tissue. It is worth noting that chronic histoplasmosis is often combined with other, no less dangerous diseases, including tuberculosis, leukemia, sarcoidosis, reticulosis.

Unfortunately, this form of illness is difficult to treat. As a rule, patients need repeated courses of therapy that help to avoid changes in lung tissue and other complications.

Desseminated histoplasmosis

This form of the disease is accompanied by secondary damage to various organ systems. What does deseminated histoplasmosis look like? Symptoms in the early stages resemble an ordinary cold. First, the body temperature rises. Then the patients have standard manifestations of body intoxication. Patients complain of aches and weakness in the body, severe headaches, nausea, vomiting, diarrhea, fatigue, chills. There is also increased sweating.

The common is histoplasmosis of the skin. In this condition, the skin tissues are affected, which is accompanied by certain symptoms. How exactly does a similar histoplasmosis look like? The photo shows that the patients have rashes of varying intensity. It can be erythema, hemorrhagic or maculopapular rash, and sometimes furunculosis.

There are other variants of the course of the disease. Often, the vital activity of pathogenic microorganisms leads to the development of abscesses of subcutaneous tissue, ulcerative stomatitis, pharyngitis, the appearance of ulcers on the external genitalia. Histoplasmosis of the eyes is accompanied by a lesion of the conjunctiva and often leads to dangerous complications, up to the loss of vision.

There are many other complications with which this form of the disease is associated. Their list includes peritonitis, choroiditis, pericarditis, lymphadenopathy, infective endocarditis, ulcerative colitis, meningitis, encephalitis, etc.

Chronic desyminated histoplasmosis proceeds more sluggishly - symptoms of intoxication are practically absent and patients turn to the doctor already in the presence of lesions of this or that organ system. Nevertheless, in almost every case, such an ailment leads to the development of severe complications.

Features of the course of the disease in children and people with weakened immunity

Even the smallest patients are not immune from a disease called histoplasmosis. Symptoms in children are quite typical. First there is a fever - the body temperature rises to about 38-39 degrees. In addition, you can notice pallor, sometimes even jaundice of the skin, which is associated with some disorders in the liver. Some parents also note the appearance of diarrhea in their child with a rather unpleasant odor. At inspection it is possible to note increase in the sizes of a spleen and a liver.

In most cases, in children, the disease proceeds according to the descendant type. The same goes for patients with a weakened immune system: they have a very serious illness, so drug therapy is essential.

Separately, it is worth mentioning about people with HIV infection, because the immune system in such patients is very weak. In the absence of therapy, all ends in death in almost 80% of cases. But with well-conducted treatment, this figure is reduced to 15%. Unfortunately, patients who are diagnosed with AIDS can not be saved - the mortality rate among this group of patients is 100%, since even large doses of the drug can not be secured against subsequent relapse. That's why patients with the fungal infection we are considering are also advised to take HIV tests.

Modern diagnostic methods

Immediately it is worth saying that only a doctor after a thorough examination can determine the patient's histoplasmosis. Diagnosis of this disease is a long process. Studies here are aimed not only at identifying the pathogen, but also on assessing the damage caused to the body by the infection.

The diagnosis is confirmed after isolation of histoplasma capsulatum from samples. For analysis, sputum from the respiratory tract, as well as rinsing water from the bronchi, are suitable. With desmisinated form of the disease, the pathogen can be found in the blood, feces, urine, cerebrospinal fluid, the contents of abscesses. The laboratory carries out bacteriological culture on a nutrient medium.

In some cases, a biopsy of the lymph nodes or bronchial tubes is required, as well as tissue removal from the edges of skin ulcers - the collected samples are then susceptible to histological examination.

This is by no means all methods by which it is possible to detect histoplasmosis. Diagnosis often involves carrying out serotonergic reactions, as well as an intradermal test with histoplasmin.

In addition, there are other studies that help to find out the state of the body. For example, the radiography of the lungs makes it possible to see large and medium-angle infiltrates that are characteristic of the acute stage of the disease.

Treatment of the disease

What if you have histoplasmosis? Treatment in this case is selected individually. Important! In no case should not disregard the advice of a doctor or refuse therapy, as this can lead to very dangerous consequences.

The choice of therapy depends on many factors. In consideration it is necessary to take the severity of the disease, its shape, the degree of damage to certain organs, the age of the patient, the state of his immune system,

Histoplasmosis of mild and moderate severity does not require the use of antifungal agents, which in themselves are quite toxic. Typically, in such cases, patients are recommended bed rest, proper nutrition, abundant drinking. Symptomatic therapy may also be performed, which may include taking antipyretics, vitamin complexes, antihistamines.

In more severe cases, antifungal therapy is necessary. For this purpose, various drugs are used. The most effective drugs are Ketoconazole, Itraconazole, Amfoglucamine, Amphotericin B. Symptomatic treatment is also necessary.In the presence of skin or eye lesions, anti-inflammatory drugs, often corticosteroids, are used.As the lungs first suffer from infection, patients are prescribed special Medicinal inhalations that help prevent tissue changes and ease the breathing of the patient.

In severe complications, surgical interventions are sometimes required, in particular removal of lymphatic angles with a strong abscess, puncture of the pericardium, prosthetics of the heart valves (if the infection affects the heart tissue), lung resection in severe complications, etc.

It should be noted that severe complications with timely and correctly conducted treatment are very rare and are most often observed among patients with a severely weakened immune system. For most people, the predictions are quite favorable - histoplasmosis is easily amenable to drug treatment, and its symptoms quickly fade.

Are there effective prevention measures?

Today, many are interested in questions about what histoplasmosis is. Symptoms and treatment, possible complications are extremely important information. On the other hand, patients often ask questions about whether it is possible to somehow prevent the onset of the disease.

Unfortunately, there is no specific preventive maintenance of the given disease - for today there are no vaccines and other medicamental agents. Histoplasmosis of the lungs, as well as any other forms of the disease, is very dangerous. Therefore, it is extremely important to observe precautions and personal hygiene rules .

For example, during construction and earth care, you need to think about protecting the respiratory tract with masks, respirators, etc. The same applies to workers in poultry farms and other agricultural institutions. You need to remember to wash fruit, especially when it comes to products brought from countries where the infection is common.

The same rules apply to tourists. In the presence of any deterioration, you need to see a doctor as soon as possible, since the earlier treatment is started, the lower the probability of development of unpleasant complications.

Histoplasmosis in animals and its features

Not only is a person susceptible to this infection. From such a disease often suffer from animals, and this occurs both in the wild and among pets. Immediately it is worth mentioning that the transmission of the pathogen in direct contact with the animal is impossible, since the fungi are excreted into the external environment together with feces. However, during the treatment of a pet you need to carefully observe the rules of personal hygiene (especially for children).

To consider the clinical picture, it is possible to examine the course of the disease in members of the feline family. So what does histoplasmosis look like in cats? Symptoms of it are not always possible to recognize from the first day.

As a rule, first there is a fever. A domestic pet becomes weak, often asleep, moves little. As the disease develops, one can observe a worsening of appetite, vomiting, rather rapid loss of weight. Often, animals develop anorexia, which further requires additional therapy.

There are some other symptoms. In particular, we can note an increase in lymph nodes, pallor of the mucous membranes, difficulty with breathing and the appearance of abnormal sounds from the lungs. Sometimes sick animals also suffer from dehydration. Upon examination, the veterinarian may notice an enlarged liver. Nevertheless, the final diagnosis can be made only after the tests, when in the laboratory culture in cultures this fungus is found.

Animals can also develop a desmisinated form, which, as a rule, is manifested by lesions of the skin, eyes, ulcers of the mucous membranes, disruption of the internal organs.

Histoplasmosis in cats is treated with antifungal drugs. In particular, "ketoconazole" and "Intraconazole" are considered quite effective. In some cases, additional restorative therapy will be required, especially if serious problems with nutrition have appeared against the background of the infection. The prognosis for most pets is favorable, especially if the animal was provided with timely assistance. But, unfortunately, at the later stages of histoplasmosis is difficult to treat - there may be relapses and the appearance of complications in the form of pathologies of the digestive system, heart, brain.