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Histoplasmosis
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Histoplamosis is also known as Darling’s decease. It is a generalized fungus infection.

Causes of Histoplasmosis

Histoplamosis or Darling’s disease is caused by an organism known as Histoplasma capsulatum. This disease is usually acquired by inhalation of dust containing spores of the fungus. This contamination chiefly occurs from excreta of birds, such as pigeons, starlings and blackbirds. This disease is widespread in its distribution and endemic in the Missisippi Valley and north eastern United States.

It is noted that in these regions near about 75 percent of the population had a primary but subclinical infection. It is estimated that 40 million people in the United States have been infected. Oral lesions of Histoplamosis are observed in large number of cases. Weed and Parkhill, have found that from 73 cases of Histoplamosis, about 24 of the cases shows the oral lesions as part of the chief complaint.

Symptoms of Histoplasmosis

First of all, in histoplasmosis, there is a chronic low-grade fever. There may also be productive cough. This infection of this disease may be extremely milk, showing only local lesions such as subcutaneous nodules or supportive arthritis. It may show no more serious effects than a positive histoplasmin skin reaction. This disease may also show calcified pulmonary nodules similar to those which are seen in tabeerculosis. But in some cases sufferers of Hispoplamosis show spleenomegaly, hepatomegaly and enlarged lymphnode known as lymphadenopahty.

It is because the organisms have a special tendency to infect the Retionloendothelial system and therefore mainly involves the spleen, liver, lymphnodes and bonemarrow. In such disease, Anaemia and leucopenia may also be present Histoplamosis often terminates fatally; however, particularly the generated form.

What is Histoplasmosis Infection?

The Oral lesions of Histoplamosis have been described by Levy and Stiff. The lesions generally appear in the form of nodule. These nodules may be ulcerative or vegetative lesions. The common sites for oral histoplamic lesions are the buccal mucosa, gingiva, tongue, palate and lips. The lesions which are ulcerated are usually covered by non-specific gray membrane and these lesions also show in duration.

In few cases, but not all, the causative organism may be demonstrated in tissue sections.

Hence, it is advisable in susceptible cases to preserve a piece of tissue at the time of biopsy for microbiological examination. The organism may be readily isolated by inoculating the emulsified tissue into blood agar containing penicillin and streptomycin. Occasionally cases have been mistaken for carcinoma or even Vincent’s infection, while the lymphadnaopahty has suggested Hodgekin’s disease.

Darling’s Disease or Histoplamosis is basically in the form of a granulomatous infection. This granulomatous infection chiefly affects the reticuloendothelial system. This organism causing Histoplasmosis are found in large numbers in phagocytic cells. These organisms appear as tiny intracellular structures and they measure little more than one micron in diameter.

Treatment of Histoplasmosis

It has been observed that the pulmonary histoplamosis which affects lungs commonly resolves spontaneously. But if the disease in its severe form then it is commonly treated by amphotericin B. Amphotericin B has been found to provide effect chemotherapeutic control of the disease. Since, it is often an opportunistic infection; the disease has increased in incidence as immuno-suppression has become more prevalent.



 

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