Diagnosis Persistent eosinophilia may be an epiphenomenon of dissemination. CXR show diffuse infiltrates in most cases, but thin walled cavities, nodules, adenopathy, or pleural effusions may also occur. KOH preparations show large thick-walled spherules. It is useful only as an epidemiologic or prognostic tool. Patients with disseminated disease should have bone scan.
Chronic suppression is indicated to prevent relapses.
Daily fluconazole 200-400 mg or weekly AMB are recommended. Itraconazole is also effective. Prophylaxis Routine skin testing in patients from endemic areas is not predictive of disease and should not be performed. Microconidia are the infectious form of the disease and they are acquired via inhalation. Clinical Syndromes Histoplasmosis is mainly a primary infection or reinfection rather than a reactivation disease.