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Skin test; histoplasmosis

CPT4 code

Name of the Procedure:

Skin Test for Histoplasmosis Technical Term: Histoplasmin Skin Test

Summary

The histoplasmin skin test is a diagnostic procedure where a small amount of histoplasmin, a substance derived from the Histoplasma capsulatum fungus, is injected just under the skin. This test determines if the body has been exposed to the fungus, which can cause a respiratory infection known as histoplasmosis.

Purpose

This procedure helps diagnose histoplasmosis, an infection caused by inhaling spores of the Histoplasma capsulatum fungus. The goal is to identify past or current exposure to this fungus to ensure timely and appropriate treatment.

Indications

  • Persistent symptoms such as cough, chest pain, and fever.
  • Living in or traveling to areas where histoplasmosis is common.
  • Immunocompromised patients with unexplained respiratory symptoms.
  • Patients with a history of exposure to bird or bat droppings, as these are common sources of the fungus.

Preparation

  • No specific fasting or dietary restrictions.
  • Inform the healthcare provider of any medications or history of allergic reactions.
  • Pre-procedure blood tests may be conducted to check overall health.

Procedure Description

  1. A small quantity of histoplasmin is injected just under the skin, usually on the forearm.
  2. The injection site is observed for a reaction over the next 48-72 hours.
  3. A positive reaction is marked by swelling and redness at the injection site, indicating exposure to the fungus.
  4. The healthcare provider will measure and evaluate the reaction at a follow-up visit.

Tools and Equipment:

  • Syringe and fine needle
  • Histoplasmin solution

Anesthesia:

  • None required, as the procedure is minimally invasive.

Duration

  • Initial injection: Approximately 10 minutes.
  • Observation period: 48-72 hours, with a follow-up visit for evaluation.

Setting

  • Outpatient clinic or healthcare provider's office.

Personnel

  • Performed by a nurse or a healthcare provider.
  • Evaluation by a primary care physician or specialist.

Risks and Complications

  • Mild discomfort or pain at the injection site.
  • Rarely, allergic reactions or severe skin reactions.
  • Itching or mild inflammation at the injection site.

Benefits

  • Provides quick and simple diagnostic information.
  • Assists in timely diagnosis and treatment of histoplasmosis.
  • Non-invasive with minimal discomfort.

Recovery

  • No specific post-procedure care required.
  • Monitor the injection site for any signs of infection or severe reactions.
  • Normal activities can usually be resumed immediately.

Alternatives

  • Serological tests: Blood tests to detect antibodies against Histoplasma.
  • Imaging tests: Chest X-ray or CT scans for severe cases.
  • Pros: Blood tests and imaging can provide more comprehensive information without injection.
  • Cons: May be more expensive or take longer to get results.

Patient Experience

  • Mild prick sensation during the injection.
  • Slight discomfort at the injection site.
  • Minimal pain that can be managed with over-the-counter pain relievers if necessary.
  • Reassurance from healthcare provider and clear instructions for post-procedure monitoring.