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Histoplasma capsulatum and Histoplasmosis

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Current Progress in Medical Mycology

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Abstract

The fungal pathogen Histoplasma capsulatum infects tens to hundreds of thousands of individuals every year. Ensuing disease severity is largely dependent on the host immune response with activation of cell-mediated immunity essential for eventual pathogen control. During the early stages of infection normally fungicidal phagocytes provide a permissive intracellular host niche for Histoplasma yeasts. These fungal elements avoid destruction by phagocytes by minimizing exposure of immunostimulatory molecules on their surface and by detoxifying antimicrobial reactive compounds produced by phagocytes. Within the phaogcyte, yeasts overcome nutrient limitations including organic sulfur, iron, and zinc. Activation of T-cells and the ensuing production of pro-inflammatory Th1 and Th17 cytokines (especially TNFα, IFNγ, and GM-CSF) stimulate phagocyte reactive oxygen and nitric oxide production, thereby changing the host–pathogen balance to favor phagocyte clearance of intracellular Histoplasma yeasts. Clinical management of histoplasmosis involves identification of susceptible individuals with functional or therapeutic reduction of factors mediating activation of cell mediated immunity and augmentation of fungal control through administration of azole- and polyene-class antifungals.

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Authors and Affiliations

  1. Division of Infectious Diseases, College of Medicine, University of Cincinnati, Cincinnati, OH, USA

    Chelsea Bueter Ph.D. & George S. Deepe M.D.

  2. Department of Microbiology, Ohio State University, Columbus, OH, USA

    Chad A. Rappleye Ph.D.

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  1. Chelsea Bueter Ph.D.
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  2. George S. Deepe M.D.
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  3. Chad A. Rappleye Ph.D.
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Correspondence to Chelsea Bueter Ph.D. or Chad A. Rappleye Ph.D. .

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  1. Universidad de Guanajuato, Guanajuato, Mexico

    Héctor M. Mora-Montes

  2. Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil

    Leila M. Lopes-Bezerra

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Bueter, C., Deepe, G.S., Rappleye, C.A. (2017). Histoplasma capsulatum and Histoplasmosis. In: Mora-Montes, H., Lopes-Bezerra, L. (eds) Current Progress in Medical Mycology. Springer, Cham. https://doi.org/10.1007/978-3-319-64113-3_5

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