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Practice Guideline
. 2026 Jan 16;81(Supplement_3):i27-i32.
doi: 10.1093/cid/ciaf256.

2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on Histoplasmosis: Treatment of Asymptomatic Histoplasma Pulmonary Nodules (Histoplasmomas) and Mild or Moderate Acute Pulmonary Histoplasmosis in Adults, Children, and Pregnant People

Sandra R Arnold  1   2 , Andrej Spec  3 , John W Baddley  4 , Peter Pappas  5 , Robert J Lentz  6 , Joshua Wolf  7 , Carol A Kauffman  8 , Monica I Ardura  9   10 , Nevert Badreldin  11 , Nathan C Bahr  12   13 , Karen Bloch  14 , Rachel A Miller  15 , Satish Mocherla  16 , Michael Saccente  17 , Ilan Schwartz  15 , Kayla R Stover  18 , Nathan P Wiederhold  19 , Jennifer Loveless  20
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Practice Guideline

2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on Histoplasmosis: Treatment of Asymptomatic Histoplasma Pulmonary Nodules (Histoplasmomas) and Mild or Moderate Acute Pulmonary Histoplasmosis in Adults, Children, and Pregnant People

Sandra R Arnold et al. Clin Infect Dis. .

Abstract

As the first part of an update to the clinical practice guideline on the management of histoplasmosis in adults, children, and pregnant people, developed by the Infectious Diseases Society of America, we present 4 updated recommendations. These recommendations span treatment of asymptomatic Histoplasma pulmonary nodules (histoplasmomas), mild acute pulmonary histoplasmosis, and moderate acute pulmonary histoplasmosis. The panel's recommendations are based on evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.

Keywords: asymptomatic pulmonary nodules; guideline; histoplasmoma; histoplasmosis.

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Conflict of interest statement

Potential conflicts of interest. Evaluation of relationships as potential conflicts of interest (COIs) is determined by a review process. The assessment of disclosed relationships for possible COIs is based on the relative weight of the financial relationship (ie, monetary amount) and the relevance of the relationship (ie, the degree to which an association might reasonably be interpreted by an independent observer as related to the topic or recommendation of consideration). The following panelists have scientific advisory/consultant roles related to the topic (ie, manageable conflicts of interest): A. S. (vice-chair) with Mayne and Scynexis, C. A. K. with Cidara Therapeutics (concluded) and Laboratoires SMB (concluded), K. R. S. with Cidara Therapeutics (concluded), and N. P. W. with F2G (concluded). C. A. K. is editor-in-chief for UpToDate's Infectious Diseases sections, and J. W. B. is an editor for UpToDate's Fungal Infections sections. The following panelists have research relationships related to the topic: A. S. (vice-chair) with Astellas; P. P. with Mayne; R. A. M. with Scynexis and F2G; and N. P. W. with F2G, Scynexis, Mycovia (concluded), and Sfunga (concluded). No disclosures were reported for all other authors (the majority of panelists), including the chair. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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