目前对免疫力正常的患者,并没有有效的预防措施。婴儿或有潜在免疫抑制疾病的患者应避免暴露于具有大量组织细胞浆菌接种物的地区以预防播散性疾病。对于HIV感染者和CD4细胞数<150个/mm^3的艾滋病人群,如果所居住地区的荚膜组织胞浆菌病的发病率大于10例/100人年,推荐使用伊曲康唑(200mg qd po)进行预防性治疗,但这一预防性治疗方案尚缺乏足够数据支持。[17]McKinsey DS, Wheat LJ, Cloud GA, et al. Itraconazole prophylaxis for fungal infections in patients with advanced human immunodeficiency virus infection: randomized, placebo-controlled, double-blind study. Clin Infect Dis. 1999;28:1049-1056.http://cid.oxfordjournals.org/content/28/5/1049.full.pdf+htmlhttp://www.ncbi.nlm.nih.gov/pubmed/10452633?tool=bestpractice.com[18]Dismukes WE, Bradsher RW Jr, Cloud GC, et al. Itraconazole therapy for blastomycosis and histoplasmosis. NIAID Mycoses Study Group. Am J Med. 1992;93:489-497.http://www.ncbi.nlm.nih.gov/pubmed/1332471?tool=bestpractice.com如果患者接受高活性的抗逆转录病毒治疗、患者的 CD4 计数>150 个细胞/mm^3、血液培养结果呈阴性,且真菌血清和尿抗原水平<2 ng/ml,则伊曲康唑可在使用 1 年后安全停用。[19]Goldman M, Zackin R, Fichtenbaum CJ, et al. Safety of discontinuation of maintenance therapy for disseminated histoplasmosis after immunologic response to antiretroviral therapy. Clin Infect Dis. 2004;38:1485-1489.http://cid.oxfordjournals.org/content/38/10/1485.fullhttp://www.ncbi.nlm.nih.gov/pubmed/15156489?tool=bestpractice.com