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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Effective Is Prednisone For Histoplasmosis ?

Re histoplasmosis in a friend. They haven t found something he responds to . Now has 37% lung function, on o2 24/7. last ditch the natl jewish doctor put him on prednisone. Where it helps with the breathing in the short run, would his immune system be further compromised?
Tue, 11 Feb 2014
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Dermatologist 's  Response
hello,

It seems your friend has developed pulmonary histoplasmosis. Treatment differs according to chronicity of the disease :
If it is acute ( recent onset ), an antifungal therapy either with itraconazole or amphotericin B. Alongwith it, prednisone therapy is needed for initial 1-2 weeks

If it is chronic, only itraconazole therapy alone is needed. In cases of severe disease like pericarditis , one need to give steroids for 1-2 weeks.
In case, he has any cavitation or any other lesion in lungs, he need surgical therapy eventually.

In all these cases, he needs to be put on antifungals. Prednisone therapy alone will eventually cause immune compromisation given for along time. However, if it has been given for 1-2 weeks along with antifungals, then I don't think you should be worried about.

I think you should discuss your doubts with his doctor because he would be in a better state to tell you the exact indications of starting these medicines and his further intentions

hoping for a speedy recovery of your friend

Regards
Dr Jyoti Gupta
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How Effective Is Prednisone For Histoplasmosis ?

hello, It seems your friend has developed pulmonary histoplasmosis. Treatment differs according to chronicity of the disease : If it is acute ( recent onset ), an antifungal therapy either with itraconazole or amphotericin B. Alongwith it, prednisone therapy is needed for initial 1-2 weeks If it is chronic, only itraconazole therapy alone is needed. In cases of severe disease like pericarditis , one need to give steroids for 1-2 weeks. In case, he has any cavitation or any other lesion in lungs, he need surgical therapy eventually. In all these cases, he needs to be put on antifungals. Prednisone therapy alone will eventually cause immune compromisation given for along time. However, if it has been given for 1-2 weeks along with antifungals, then I don t think you should be worried about. I think you should discuss your doubts with his doctor because he would be in a better state to tell you the exact indications of starting these medicines and his further intentions hoping for a speedy recovery of your friend Regards Dr Jyoti Gupta