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Histoplasmosis (cont.)

Histoplasmosis Complications

The majority (about 90%) of people infected with H. capsulatum recover completely with no complications. A few people may show small areas of lung scarring on chest X-rays while pleural effusions (fluid around the lung) and pericarditis can develop in about 5% of acute symptomatic patients. Another 5% may develop rheumatologic problems like arthritis or skin disorders such as erythema nodosum or erythema multiforme. Individuals with chronic pulmonary histoplasmosis may develop cavitary lung lesions, pulmonary fibrosis, dyspnea (shortness of breath), or adrenal gland infections, which may be rarely associated with Cushing's syndrome. Others may develop ocular histoplasmosis syndrome where H. capsulatum spreads from the lungs to the retinal blood vessels, which may result in partial blindness. Acute progressive disseminated histoplasmosis patients may develop CNS problems that result in encephalopathy or seizures, adrenal insufficiency, cardiac problems such as valve failure, angina, and poor cardiac output. Acute progressive disseminated histoplasmosis, if not treated quickly and appropriately, can lead to death in a few weeks. Even with lifelong antifungal treatment, about 10%-20% of people with disseminated disease will relapse.

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