B39.2 Pulmonary histoplasmosis capsulati, unspecified

ICD10CM code

#### Name of the Condition
- Common Name(s): Pulmonary Histoplasmosis
- Technical Term: Histoplasmosis capsulati, unspecified

#### Summary
Pulmonary histoplasmosis is a fungal infection caused by inhaling spores of the Histoplasma capsulatum fungus, primarily affecting the lungs. This condition is similar to tuberculosis in terms of symptoms and radiological findings and is most often seen in regions with high levels of bird or bat droppings.

#### Causes
Histoplasmosis is caused by inhaling spores from the Histoplasma capsulatum fungus, which is commonly found in environments with bird or bat droppings, such as caves or old buildings. The spores become airborne when these areas are disturbed.

#### Risk Factors
- Living or traveling in endemic areas (e.g., Ohio and Mississippi River valleys)
- Exposure to bird or bat droppings
- Activities like spelunking, demolition, or handling soil that may lead to spore inhalation
- Weakened immune system

#### Symptoms
- Fever
- Cough
- Fatigue
- Chest pain
- Shortness of breath
- In severe cases, can mimic symptoms of tuberculosis or other chronic lung conditions

#### Diagnosis
- Chest X-ray or CT scan for lung abnormalities
- Fungal culture or antigen tests from lung, blood, or urine samples
- Serological tests to identify antibodies to Histoplasma
- Bronchoscopy for direct sample collection from the lungs

#### Treatment Options
- Mild cases often resolve without treatment
- Antifungal medications like itraconazole for moderate to severe cases
- Amphotericin B for life-threatening cases or immune-compromised patients
- Corticosteroids in cases of severe lung inflammation

#### Prognosis and Follow-Up
- Prognosis is generally good with treatment, especially in healthy individuals
- Chronic cases can lead to lung damage if not treated
- Regular follow-ups may be necessary to monitor for recurrence or complications

#### Complications
- Chronic pulmonary histoplasmosis, leading to lung damage
- Disseminated histoplasmosis, spreading throughout the body, particularly in immunocompromised individuals
- Fibrosing mediastinitis causing compression of blood vessels and airways

#### Lifestyle & Prevention
- Avoiding areas with high bird or bat droppings
- Wearing protective gear in endemic areas
- Ensuring proper ventilation in potentially contaminated sites

#### When to Seek Professional Help
- Persistent cough or chest pain
- Unexplained fever or night sweats
- Rapidly worsening symptoms, particularly if immune-compromised

#### Additional Resources
- Centers for Disease Control and Prevention (CDC) [website](https://www.cdc.gov/fungal/diseases/histoplasmosis/index.html)
- American Lung Association [website](https://www.lung.org/)

#### Tips for Medical Coders
- Ensure accurate documentation of patient history and risk factors
- Be aware that histoplasmosis can mimic other conditions like pneumonia or tuberculosis
- Verify if the condition is acute or chronic when coding

Medical Policies and Guidelines for Pulmonary histoplasmosis capsulati, unspecified

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