ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Histoplasmosis-related Healthcare Use, Diagnosis, and Treatment in a Commercially Insured Population, United States.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Histoplasmosis: A systematic review to inform the World Health Organization of a fungal priority pathogens list.Medical mycology · 2024Pooled it
- Gastric Involvement With Disseminated Histoplasmosis in an Immunocompetent Patient From a Nonendemic Region.ACG case reports journal · 2026Article
- Histoplasma antigen detection: A laboratory-based retrospective review of routine testing from 2021 to 2023.Biomedica : revista del Instituto Nacional de Salud · 2026Article
- Disseminated histoplasmosis presenting as primary adrenal insufficiency in an immunocompetent host in the United States: a case report.BMC infectious diseases · 2026Article
- Histoplasmosis with mediastinal lymphadenopathy in an immunocompetent municipal water department employee in Texas: a case report.Frontiers in cellular and infection microbiology · 2026Article
- Updating the Epidemiology of Blastomycosis and Histoplasmosis in the United States, Using National Electronic Health Record Data, 2013-2023.The Journal of infectious diseases · 2025Article
- Impact of Delays in Diagnosis on Healthcare Costs Associated With Blastomycosis, Coccidioidomycosis, and Histoplasmosis in a Commercially Insured Population.Open forum infectious diseases · 2025Article
- Practical Guidance for Clinical Microbiology Laboratories: Antibody and antigen detection methods for dimorphic fungal infections.Clinical microbiology reviews · 2025Review
- Usefulness of Serum as a Non-Invasive Sample for the Detection ofJournal of fungi (Basel, Switzerland) · 2025Article
- An unusual case of a dry cough.Breathe (Sheffield, England) · 2024Article
- Evaluation of Turnaround Times for Antigen Testing in Hospitalized Patients With Histoplasmosis and Blastomycosis.Open forum infectious diseases · 2024Article
- Using Insurance Claims Data to Estimate Blastomycosis Incidence, Vermont, USA, 2011-2020.Emerging infectious diseases · 2024Article
- Progressive disseminated histoplasmosis: The experience in one non-endemic medical center.Medical mycology · 2023Article
- Article
- Fungal Pathogens as Causes of Acute Respiratory Illness in Hospitalized Veterans: Frequency of Fungal Positive Test Results Using Rapid Immunodiagnostic Assays.Journal of fungi (Basel, Switzerland) · 2023Article
- A clinically-guided unsupervised clustering approach to recommend symptoms of disease associated with diagnostic opportunities.Diagnosis (Berlin, Germany) · 2023Article
- Development of an Interferon-Gamma Release Assay (IGRA) to Aid Diagnosis of Histoplasmosis.Journal of clinical microbiology · 2022Article
- Diagnostic delays in infectious diseases.Diagnosis (Berlin, Germany) · 2022Article
- Management of Histoplasmosis by Infectious Disease Physicians.Open forum infectious diseases · 2022Article
- Emerging Animal-Associated Fungal Diseases.Journal of fungi (Basel, Switzerland) · 2022Review
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundInfections with Histoplasma can range from asymptomatic to life-threatening acute pulmonary or disseminated disease. Histoplasmosis can be challenging to diagnose and is widely underrecognized. We analyzed insurance claims data to better characterize histoplasmosis testing and treatment practices and its burden on patients.
methodsWe used the IBM MarketScan Research Databases to identify patients with histoplasmosis (International Classification of Diseases, Ninth Revision, Clinical Modification codes 115.00-115.99) during 2012-2014. We analyzed claims in the 3 months before to the 1 year after diagnosis and examined differences between patients with probable (hospitalized or >1 outpatient visit) and suspected (1 outpatient visit) histoplasmosis.
resultsAmong 1935 patients (943 probable, 992 suspected), 54% had codes for symptoms or findings consistent with histoplasmosis and 35% had ≥2 healthcare visits in the 3 months before diagnosis. Overall, 646 (33%) had any fungal-specific laboratory test: histoplasmosis antibody test (n = 349 [18%]), Histoplasma antigen test (n = 349 [18%]), fungal smear (n = 294 [15%]), or fungal culture (n = 223 [12%]); 464 (24%) had a biopsy. Forty-nine percent of probable patients and 10% of suspected patients were prescribed antifungal medication in the outpatient setting. In total, 19% were hospitalized. Patients' last histoplasmosis-associated healthcare visits occurred a median of 6 months after diagnosis.
conclusionsSome histoplasmosis patients experienced severe disease, apparent diagnostic delays, and prolonged illness, whereas other patients lacked symptoms and were likely diagnosed incidentally (eg, via biopsy). Low rates of histoplasmosis-specific testing also suggest incidental diagnoses and low provider suspicion, highlighting the need for improved awareness about this disease.
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