1. Infeksi Jamur pada Paru
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2. Histoplasmosis: Ohio Valley Fever
• Histoplasma capsulatum – most common true
pathogen; causes histoplasmosis
• Distributed worldwide, most prevalent in eastern and
central regions of US
• Grows in moist soil high in nitrogen content
• Inhaled conidia produce primary pulmonary infection
that may progress to systemic involvement of a variety
of organs and chronic lung disease.
• Amphotericin B, ketoconazole
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3. PORTAL OF ENTRY
INHALATION
INOCULATION
(rare)

4. 4

5. Cause
• Spores
– trapped by
macrophages
– germinate in
lungs
• Infection spreads
through body in
blood stream

6. Acute Symptoms
 Asymptomatic: in
› No symptoms
› Most common
 Symptomatic:
› Fever
› Chills/Sweats › Muscle Aches
› Cough › Loss of appetite
› Chest pain breathing

7. Chronic Symptoms
 5% of those who are infected
› Chronic histoplasmosis
 Chest pain  Fever
 Shortness of breath  Excessive sweating
 Cough
› May bring up blood
 Weight loss

8. Disseminated Symptoms
Fevers Anemia
Headache Weight loss:
Pneumonia › Diarrhea
Neck stiffness › Loss of appetite
› Swollen lymph nodes Infection of heart
Skin lesions valves
› Mouth and nose
sores

9. Other Symptoms
• Enlarged
– Liver
– Spleen
– Adrenal gland
• Joint pain
• Rashes
• Skin nodules
– tender red lumps
• erythema nodosum

10. Diagnosis
• Fungal culture
• Fungal stain
• Blood test
• Chest X-ray
– distinct markings on lungs
• CT scan
• Transbronchial biopsy

11. CLINICAL SPECIMENS
• SPUTUM
• BONE MARROW
• BIOPSY MATERIAL
• BRONCHIAL WASHINGS
• PERIPHERAL BLOOD
• GASTRIC WASHINGS

12. Identification
• 1. Microscopic observation
• 2. Conversion
• 3. DNA Probe

13. SEROLGICAL TEST
• COMPLEMENT FIXATION
– MYCELIAL FORM ANTIGEN
– YEAST FORM ANTIGEN
• IMMUNODIFFUSION
– H = ACUTE INFECTION
– M = PAST, PRESENT OR SKIN TEST

14. SEROLGICAL TESTS
• EIA detects antibody
• EIA to detect ANTIGEN
(systemic disease)

15. ECOLOGICAL ASSOCIATION
• Blackbird roosts
• Bats
• Bat guano
• Chicken houses

16. Treatment
 Antifungal drugs
› IV
 Amphotericin B (Fungizone IV, Abelcet)
› Oral
 Itraconazole (Sporanox)
 Ketoconazole

17. Prevention
• Minimize exposure to dust in contaminated
environments
– Chicken coops
– Bat caves
• Wear breathing apparatus
– Masks
• Spray contaminated soil