**5. Treatment**

The preferred medications for treating histoplasmosis are intravenous amphotericin B and itraconazole. However, these medications are extremely expensive and scarcely available in Africa. Therefore, the antifungal medications used to treat Hcd and Hcc infection, primarily intravenous amphotericin B and itraconazole, must be made available at a lower cost [3]. Histoplasmosis laboratory diagnosis typically takes a long turnaround time, which raises the risk of the disease progressing.

Whether or not a patient exhibits notable symptoms, doctors have two alternatives for starting treatment for those with a high probability of having histoplasmosis: intravenous (IV) amphotericin B or oral itraconazole [30]. Even though it is frequently fungicidal and has proven beneficial in terms of survival, amphotericin B is nephrotoxic [73]. Liposomal amphotericin is superior to traditional amphotericin B for treating disseminated histoplasmosis, especially in AIDS patients with compromised immune systems [73]. For the majority of isolates of *H. capsulatum*, itraconazole is similarly fungicidal; however, oral capsules are not always well absorbed in advanced AIDS patients, and it is linked to numerous medication interactions, including rifampicin for situations when TB is present. Itraconazole is a good alternative for subacute disseminated infection, but amphotericin B is preferred for the initial treatment of AIDS-related disseminated histoplasmosis [30]. Amphotericin B is unlicensed and unavailable in several African nations, which is concerning yet when available, the price could be exorbitant [74]. Amphotericin B liposomal is extremely expensive and unavailable throughout most of Africa. Despite being accessible in the most of African nations, itraconazole is excessively expensive [74].
