Comparison of Treated and Untreated Severe Histoplasmosis

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Abstract
Comparison of 194 patients with severe histoplasmosis treated with amphotericin B with a group of 115 untreated patients revealed that adequate dosage with the drug improved prognosis. Inadequate dosage, ie, less than a total of 25 mg/kg of body weight, delayed progression of the disease and decreased the mortality rate temporarily. By the third anniversary of diagnosis, the inadequately treated patients showed little difference from the untreated. However, those with adequately treated chronic pulmonary histoplasmosis showed sustained improvement and lowered mortality rate when compared with the untreated patients. Surgery done when amphotericin B has been given appears safer than surgery without drug coverage. Patients with disseminated involvement, 15% of the total, showed the most dramatic results with treatment. The disease was fatal in 83% of the untreated patients, as contrasted to 23% of the treated patients.

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