GEORGE A. SAROSI, M.D.; DOUGLAS W. VOTH, M.D.; BERNHOFF A. DAHL, M.D.; IRENE L. DOTO, M.A.; FRED E. TOSH, M.D.
Fifty-four cases of disseminated histoplasmosis were studied between 1947 and 1969 in eight hospitals in a cooperative study. Twenty-four patients received amphotericin B intravenously; of the 30 untreated patients, eight were diagnosed only at necropsy. All but three of the treated patients survived at least 8 months, and nine are currently alive (an average of 62 months after treatment). By contrast, only two of the untreated patients are still alive, 16 having died within 4 months after diagnosis. Improvement correlated well with early amphotericin therapy and a total dose of 38 mg/kg body weight. Adrenal insufficiency developed in half of the patients regardless of treatment and was the commonest cause of death. Only two patients with this complication are still alive. All patients with disseminated histoplasmosis should be evaluated carefully and repeatedly for adrenal gland insufficiency.
SAROSI GA, VOTH DW, DAHL BA, DOTO IL, TOSH FE. Disseminated Histoplasmosis: Results of Long-Term Follow-up: A Center for Disease Control Cooperative Mycoses Study. Ann Intern Med. ;75:511–516. doi: 10.7326/0003-4819-75-4-511
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Published: Ann Intern Med. 1971;75(4):511-516.
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