Histoplasmosis

  1. General information: a systemic fungal disease caused by inhalation of dust contaminated by Histoplasma capsulatum which is transmitted through bird manure.
  2. Medical management: antifungal agent Amphotericin B
    1. Very toxic: toxicity includes anorexia, chills, fever, headache, and renal failure
    2. Acetaminophen, Benadryl, and steroids given with Amphotericin B to prevent reactions
  3. Assessment findings
    1. Symptoms similar to tuberculosis or pneumonia
      1. Cough
      2. Fever
      3. Joint pain
      4. Malaise
    2. Sometimes asymptomatic
    3. Diagnostic tests
      1. Chest x-ray (often appears similar to tuberculosis)
      2. Histoplasmin skin test (read the same as PPD)
  4. Nursing interventions
    1. Monitor respiratory status
    2. Administer medications as ordered; observe for severe side effects of Amphotericin B: fever (acetaminophen given prophylactically), anaphylactic reaction (Benadryl and steroids given prophylactically), abnormal renal function with hypokalemia and azotemia.

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