American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the treatment for mild to moderate acute pulmonary histoplasmosis?

1. Amphotericin B

2. Fluconazole

3. Itraconazole

4. Lipid formulation of amphotericin B

The correct answer is: Itraconazole

Mild to moderate acute pulmonary histoplasmosis is typically treated with itraconazole. This antifungal agent is effective against Histoplasma capsulatum, the organism responsible for the infection. Itraconazole is well-tolerated and can be administered orally, making it a suitable option for outpatient treatment of this condition. In cases of mild to moderate disease, patients generally do not require hospitalization or intravenous therapy, which is where amphotericin B and its lipid formulations would typically be reserved for more severe cases. Fluconazole, while effective for certain fungal infections, is not the preferred treatment for histoplasmosis, particularly for acute pulmonary forms. By using itraconazole, the treatment can manage the infection while minimizing potential side effects and promoting a quicker recovery in patients with this degree of severity.