Histoplasma capsulatum. Methenamine silver stain showing histopathologic changes in histoplasmosis. (Source: Centers for Disease Control and Prevention Public Health Image Library)
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Histoplasmosis

Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. Its symptoms vary greatly, but the disease primarily affects the lungs. Occasionally, other organs are affected—this form of the disease is called disseminated histoplasmosis, and it can be fatal if untreated. more...

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H. capsulatum is found throughout the world and is endemic in certain areas of the United States. The fungus has been found in poultry house litter, caves, areas harboring bats, and in bird roosts(especially Starlings).

Incidence

Positive histoplasmin skin tests occur in as many as 80% of the people living in areas where H. capsulatum is common, such as the eastern and central United States. Infants, young children, and older persons, in particular those with chronic lung disease, are at increased risk for severe disease. Disseminated disease is more frequently seen in people with cancer or AIDS.

Causes

H. capsulatum grows in soil and material contaminated with bat or bird droppings. Spores become airborne when contaminated soil is disturbed. Breathing the spores causes infection. The disease is not transmitted from an infected person to someone else.

Transmission

H. capsulatum grows in soil and material contaminated with bat or bird droppings. Spores become airborne when contaminated soil is disturbed. Breathing the spores causes infection. The disease is not transmitted from an infected person to someone else.

Symptoms

If symptoms occur, they will start within 3 to 17 days after exposure; the average is 10 days. Most infected persons have no apparent ill effects. The acute respiratory disease is characterized by respiratory symptoms, a general ill feeling, fever, chest pains, and a dry or nonproductive cough. Distinct patterns may be seen on a chest x-ray. Chronic lung disease resembles tuberculosis and can worsen over months or years. The disseminated form is fatal unless treated.

Treatment

Antifungal medications are used to treat severe cases of acute histoplasmosis and all cases of chronic and disseminated disease. Mild disease usually resolves without treatment. Past infection results in partial protection against ill effects if reinfected.

Prevention

It is not practical to test or decontaminate most sites that may be contaminated with H. capsulatum, but the following precautions can be taken to reduce a person's risk of exposure:

  • Avoid areas that may harbor the fungus, e.g., accumulations of bird or bat droppings.
  • Before starting a job or activity having a risk for exposure to H. capsulatum, consult the NIOSH/NCID Document Histoplasmosis: Protecting Workers at Risk. This document contains information on work practices and personal protective equipment that will reduce the risk of infection.

Note: The original version of this article is adapted from the U.S. CDC public domain document at

Read more at Wikipedia.org


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What is histoplasmosis? How is it treated? - Information from Your Family Doctor
From American Family Physician, 12/15/02

What is histoplasmosis?

Histoplasmosis (say this: hiss-toe-plaz-mo-sis) is an infection caused by a fungus. The infection is in your lungs. In severe cases, it could spread through your whole body.

How did I get histoplasmosis?

The fungus that causes histoplasmosis grows in the ground. Farming, gardening, or any activity that disturbs the soil can let fungus spores get into the air. If you breathe in those spores, you can get the infection.

You can't catch histoplasmosis from another person or from an animal. Birds do not carry the infection, but their droppings provide food for the fungus in the ground. Bats can also get infected with histoplasmosis. Their droppings feed the fungus in the ground and can also be a source of infection for people.

Where are histoplasmosis infections common?

Histoplasmosis occurs in places that have moderate temperatures and moisture. It is very common in people who live in the Ohio and Mississippi river valleys.

Who is most likely to get histoplasmosis?

Forty million people in the United States have been infected with histoplasmosis. About a half million new cases occur each year. Most infected people have few or no symptoms.

Severe infections may develop in children under age 2 and in adults older than 55. People who have human immunodeficiency virus (HIV) infection or cancer, and those who are taking some medicines are more likely to get it. A chronic infection can occur in patients with lung diseases like emphysema (say this: em-fa-see-ma).

How does my doctor know I am infected?

Most healthy people who are infected with this fungus never have any symptoms, because their bodies fight off the disease. In people who do get symptoms, fever, headache, cough, chills, sweats, chest pain, fatigue, muscle aches, and weight loss are the most common.

Your doctor can test your blood or urine, or take a sample of tissue for testing if he or she thinks that you might have histoplasmosis. Chest x-rays are helpful, but your doctor can't be sure you have histoplasmosis just by looking at an x-ray.

How is histoplasmosis treated?

The treatment depends on how bad the infection is and how long the illness has lasted. Many people don't need any treatment. Some people have to take an antifungal medicine. If you need to take medicine for this fungus, your doctor will watch out for possible bad effects on your kidney or liver from the medicine.

What can I expect?

Some people have to go to the hospital to get oxygen therapy and intravenous fluids. Others can be treated at home. Most people do well with treatment. You may need to take medicine for weeks or months. If you have acquired immunodeficiency syndrome (AIDS), you might take this medicine for the rest of your life.

Is there any way to not get histoplasmosis?

The best way to not get this infection is to stay away from places where you could breathe in contaminated dust. Spraying the area with water can reduce the dust that gets stirred up by cleaning chicken coops or digging in the dirt. If you work in contaminated areas, you can wear protective clothing and face masks.

COPYRIGHT 2002 American Academy of Family Physicians
COPYRIGHT 2003 Gale Group

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