Semin Respir Crit Care Med 2008; 29(2): 151-165
DOI: 10.1055/s-2008-1063854
© Thieme Medical Publishers

Pulmonary Histoplasmosis

Chadi A. Hage1 , 3 , L. Joseph Wheat4 , James Loyd5 , Stephen D. Allen2 , Deborah Blue2 , Kenneth S. Knox1 , 3
  • 1Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
  • 2Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana
  • 3Roudebush VA Medical Center, Indianapolis, Indiana
  • 4MiraVista Diagnostics and MiraBella Technologies, Indianapolis, Indiana
  • 5Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Further Information

Publication History

Publication Date:
26 March 2008 (online)


Pulmonary manifestations of histoplasmosis were last reviewed in Seminars in 2004. This review highlights the management of the most common clinical syndromes, emphasizing recognition, diagnosis, and treatment. The reader is referred to the earlier review for subjects not fully addressed herein. Knowledge of the utility of serological testing is essential, particularly when antigen tests and cultures are negative. Antigen testing is most useful in patients with more diffuse pulmonary involvement and those with progressive disseminated disease due to the high fungal burden. Detection of antigen in bronchoalveolar lavage fluid may be particularly helpful in certain circumstances. Guidelines for antifungal therapy have been updated and will be discussed for pulmonary syndromes.


L. Joseph Wheat, M.D. 

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