Concurrent Histoplasmosis & Blastomycosis in a Young Woman

Current treatment of histoplasmosis in immunocompetent individuals depends on the duration of the disease. Acute infections do not warrant treatment. If symptoms persist, a three-month course of itraconazole is recommended. Amphotericin B is considered in patients unable to take itraconazole or for those with severe disease. Blastomycosis ranges from asymptomatic to a deadly pulmonary infection. While spontaneous remission of mildly symptomatic blastomycosis can occur, treatment with itraconazole is often recommended. Amphotericin B is reserved for severe pulmonary infection, disseminated blastomycosis, or central nervous system blastomycosis. Immunocompromised patients represent a population at significantly elevated risk for disseminated fungal disease as well as severe pulmonary infection from fungal disease.