In cases where histoplasmosis has spread to other body systems, the antifungal agents amphotericin B and ketoconazole are effective. Itraconazole may be effective in immunocompromised patients, in whom the disease can be more serious.

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Histoplasmosis most commonly occurs in the Mississippi Valley of the United States, and is commonly referred to as the "Mississippi Valley Fever." It is acquired by inhaling microconidial spores in the air. It not transmitted from human to human. The causative agent is *Histoplasma capsulatum.*

Histoplasmosis

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Signs and symptoms of respiratory histoplasmosis include fever, headache, and weakness with some chest discomfort. The initial diagnosis is often based on chest radiographs and cultures grown on fungal selective media

Signs and Symptoms of Histoplasmosis 

Diagnosis of histoplasmosis is often based on chest radiographs and cultures grown on fungal selective media like Sabouraud's dextrose agar. Direct fluorescence antibody staining and Giemsa staining can also be used for diagnosis. In addition, serological tests including a complement fixation assay and histoplasmin sensitivity can be used to confirm the diagnosis.

Diagnosis of Histoplasmosis

Treatment of Histoplasmosis

Following inhalation, the spores enter the lungs and are phagocytized by alveolar macrophages. The fungal cells then survive and multiply within these phagocytes. Focal infections cause the formation of granulomatous lesions, which can lead to calcifications that resemble the Ghon complexes of tuberculosis, even in asymptomatic cases. Histoplasmosis can become chronic and reactivation can occur, along with dissemination to other areas of the body

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