245 Ch 245. Histoplasmosis

Most common endemic mycosis USA (Ohio + Mississippi River valleys); Histoplasma capsulatum dimorphic fungus; bat + bird droppings (caves, chicken coops, old buildings); spectrum: asymptomatic (90%) → acute pulmonary → chronic pulmonary → disseminated (HIV/immunocompromise — life-threatening); itraconazole for mild-moderate, amphotericin B for severe; urinary antigen rapid diagnostic; 公式 considerations for HIV pediatric + maternal。