Kauffman Carol A
University of Michigan Medical School, Infectious Diseases Division, Veterans Affairs Healthcare System, Ann Arbor, Michigan, USA.
Expert Opin Pharmacother. 2002 Aug;3(8):1067-72. doi: 10.1517/14656566.3.8.1067.
Histoplasmosis is a systemic fungal infection that infects millions of people living in areas where the infection is endemic. However, most people with histoplasmosis have a self-limited illness that does not require treatment with an antifungal agent. Patients who do require treatment are those who are immunosuppressed, those who are exposed to a large fungal inoculum that overwhelms their immune system, and those who have symptomatic disseminated infection, chronic pulmonary infection, or focal organ involvement. The treatment of choice for severe histoplasmosis is amphotericin B, while itraconazole is given for mild to moderate histoplasmosis. Most patients who require initial treatment with amphotericin B respond quickly and can then be switched to itraconazole to finish the course of therapy.
组织胞浆菌病是一种全身性真菌感染，感染着生活在该病流行地区的数百万人。然而，大多数组织胞浆菌病患者病情会自我局限，无需使用抗真菌药物治疗。确实需要治疗的患者包括免疫功能低下者、接触大量真菌接种物以致免疫系统不堪重负者，以及出现症状性播散感染、慢性肺部感染或局灶性器官受累的患者。重症组织胞浆菌病的首选治疗药物是两性霉素B，而轻度至中度组织胞浆菌病则使用伊曲康唑治疗。大多数需要初始使用两性霉素B治疗的患者反应迅速，之后可改用伊曲康唑完成治疗疗程。
