a type of lung infection. It is caused by inhaling Histoplasma
capsulatum fungal spores. These spores are found in soil and in the
droppings of bats and birds. This fungus mainly grows in the central,
southeastern, and mid-Atlantic states.
Most cases of histoplasmosis don’t require treatment. However,
people with weaker immune systems may experience serious problems. The disease
may progress and spread to other areas of the body. Skin lesions have been reported in 10 to
15 percent of cases of histoplasmosis that has spread throughout the body.
Should I Watch For?
Most people who are infected with this fungus have no symptoms.
However, the risk of symptoms increases as you breathe in more spores. If you
are going to have symptoms, they generally show up about 10 days after
Possible symptoms include:
- dry cough
- chest pain
- joint pain
- red bumps on your lower legs
In severe cases, symptoms may include:
- excessive sweating
- shortness of breath
- coughing up blood
Widespread histoplasmosis causes inflammation and irritation.
Symptoms may include:
- chest pain, caused by swelling around the heart
- high fever
- stiff neck and headaches, from swelling around
the brain and spinal cord
Fungal spores can be released into the air when contaminated soil
or droppings are disturbed. Breathing the spores may lead to an infection.
The spores that cause this condition are commonly found in places
where birds and bats have roosted, such as:
- chicken coops
- older barns
You can get histoplasmosis more than once. However, the first
infection is generally the most severe.
The fungus doesn’t spread from one person to another and it’s not
Acute, or short-term, histoplasmosis is typically mild. It rarely
leads to complications.
The Centers for Disease Control and Prevention (CDC) estimate
that between 60 and 90 percent of
people who live in areas where the fungus is common have been exposed. Many of these
people probably did not have any symptoms of infection.
Chronic, or long-term, histoplasmosis occurs far less often than
the acute form. In rare cases, it can spread throughout the body. Once
histoplasmosis has spread throughout your body it is life-threatening if it
Widespread disease usually occurs in people with impaired immune
systems. In areas where the fungus is common, the CDC says that it may occur in
up to 30 percent of people
I at Risk?
There are two major risk factors for developing this disease. The
first is working in a high-risk occupation and the second risk factor is having
a compromised immune system.
You are more likely to be exposed to histoplasmosis if your job
exposes you to disturbed soil or animal droppings. High-risk jobs include:
- construction worker
- pest control worker
- demolition worker
Weakened Immune Systems
Many people who have been exposed to histoplasmosis do not get
noticeably sick. However, your risk of severe infection is higher if you have a
compromised immune system. Conditions associated with weakened immunity
- being very young or very old
- having HIV or AIDS
- taking strong anti-inflammatory medications like
- undergoing chemotherapy for cancer
- taking TNF inhibitors for conditions such as
- taking immunosuppressant drugs to prevent a
Long-Term Complications of Infection
In rare cases, histoplasmosis can be life-threatening. Therefore,
it is extremely important to get treatment.
Histoplasmosis can also cause a number of complications.
Acute Respiratory Distress Syndrome
Acute respiratory distress syndrome can develop if your lungs
fill with fluid. This can lead to dangerously low levels of oxygen in your
Heart Function Issues
Your heart might not be able to function normally if the area
around it becomes inflamed and full of fluid.
Histoplasmosis can cause a serious condition called
meningitis. Meningitis occurs
when the membranes surrounding your brain and spinal cord become infected.
Adrenal Glands and Hormone Problems
Infection can damage your adrenal glands and this may cause
problems with hormone production.
for and Diagnosing Histoplasmosis
If you have a mild case of histoplasmosis, you may never know
that you were infected. Testing for histoplasmosis is usually reserved for
people who both have a severe infection and live or work in a high-risk area.
To confirm a diagnosis, your doctor may conduct blood or urine
tests. These tests check for antibodies or other proteins that indicate prior
contact with histoplasmosis. Your doctor might also take urine, sputum, or
blood cultures to make an accurate diagnosis. However, it can take up to six weeks
to get results.
Depending on what parts of your body are affected, you may need
other tests. Your doctor might take a biopsy (tissue sample) of your lung, liver, skin, or
bone marrow. You might also need an X-ray or computerized tomography (CT) scan
of your chest. The purpose of these tests is to determine if additional
treatments are needed to address any complications.
If you have a mild infection, you probably won’t need treatment.
Your doctor might instruct to you rest and take an over-the-counter medication
If you have trouble breathing or are infected for longer than one
month, treatment may be necessary. You will likely be given an oral antifungal
medication, but you may also require IV treatment. The most commonly used drugs
- amphotericin B
If you have a severe infection, you might need to take your
medication intravenously (through
a vein). This is how the strongest medications are delivered. Some people may
have to take antifungal medication for up to two years.
Can I Prevent Histoplasmosis?
You can reduce your risk of infection by avoiding high-risk
areas. These include:
- construction sites
- renovated buildings
- pigeon or chicken coops
If you can’t avoid high-risk areas, there are steps you can take
to help keep spores from getting into the air. For example, spray sites with
water before working or digging in them. Wear a respirator mask when there is a
high risk of exposure to spores. Your employer is obligated to provide you with
appropriate safety equipment if it’s needed to protect your health.