Which treatment is generally recommended for acute pulmonary disease related to Histoplasmosis?

In cases of acute pulmonary histoplasmosis, the majority of patients experience a self-limiting illness and do not require specific antifungal treatment. Most individuals will recover with supportive care alone, which can include rest and hydration. Therefore, a "no treatment required" approach is generally recommended for those who are asymptomatic or have mild symptoms. This reflects the understanding that many forms of acute histoplasmosis are indeed self-resolving, and treatment may not significantly alter the course of the disease in these cases.

When treatment is considered, it is usually in the context of more severe or progressive disease, especially in immunocompromised individuals or those with significant respiratory distress. In such situations, the use of antifungal therapy, particularly itraconazole or other systemic antifungals, becomes important. However, the routine management of uncomplicated acute pulmonary histoplasmosis does not necessitate immediate antifungal therapy, as most patients will improve without it.