Type of histoplasmosisTreatment of severe manifestationsTreatment of moderate or mild manifestations
Acute pulmonaryAmphotericin B (Fungizone IV), 0.7 mg per kg per day* with corticosteroids (prednisone [Deltasone], 60 mg daily for 2 weeks), then itraconazole (Sporanox), 200 mg once or twice daily* for 12 weeksSymptoms less than four weeks: none
Symptoms more than four weeks: itraconazole, 200 mg once or twice daily for six to 12 weeks
Chronic pulmonaryAmphotericin B, then itraconazole for 12 to 24 monthsItraconazole for 12 to 24 months
Disseminated (in patients without AIDS)Amphotericin B, 0.7 to 1.0 mg per kg per day, then itraconazole for six to 18 months§Itraconazole for six to 18 months
Disseminated (in patients with AIDS)Induction: amphotericin B, then itraconazole, 200 mg twice daily, to complete a 12-week courseInduction: itraconazole, 200 mg three times daily for three days, then twice daily to complete a 12-week course
Maintenance: itraconazole for life
Maintenance: itraconazole for life
Granulomatous mediastinitisAmphotericin B, then itraconazole for six to 12 months; also consider corticosteroids and/or surgical resectionItraconazole for six to 12 months
PericarditisCorticosteroids and/or pericardial drainageNSAIDs for two to 12 weeks
RheumatologicNSAIDs for two to 12 weeksNSAIDs for two to 12 weeks