Histoplasmosis

Description

Histoplasmosis is an infection caused by inhaling the spores of a fungus often found in bird and bat droppings. People usually get it from breathing in these spores, when they become in the air during demolition or cleanup projects.

Soil contaminated by bird or bat droppings can also spread histoplasmosis, putting farmers and gardeners are at a greater risk of the disease. In the united States, histoplasmosis commonly occurs in the Mississippi and Ohio river valleys. But it can occur in other areas, too. It also occurs in Africa, Asia, Australia, and in parts of Central and South America.

Most people with histoplasmosis never develop symptoms and do not know they are infected. But for some people — mainly children and people with weak immune systems, histoplasmosis can be severe. Treatments are available for even the most severe forms of histoplasmosis.

Symptoms

The more mild forms of histoplasmosis not cause any signs or symptoms. But severe infections can be life-threatening. When signs and symptoms usually appear 3 to 17 days after exposure and can include:

  • Fever
  • Chills
  • Headache
  • Muscle aches
  • Dry cough
  • Pain in the chest
  • Fatigue

Some people with histoplasmosis also obtain the joint pain and rash of the skin. People who have a lung disease, such as emphysema, may develop chronic histoplasmosis.

The signs of chronic histoplasmosis may include weight loss and bloody cough. Histoplasmosis chronic symptoms often resemble those of tuberculosis.

Severe histoplasmosis

The most severe of the variety of histoplasmosis occurs mainly in children and people with weakened immune systems. Called disseminated histoplasmosis, which can affect almost any part of your body, including the mouth, liver, central nervous system, skin, and adrenal glands. If not treated, disseminated histoplasmosis is usually fatal.

When to see a doctor

Contact your health-care provider if they develop flu-like symptoms after exposure to the droppings of birds or bats — especially if you have a weakened immune system.

Causes

Histoplasmosis is caused by the reproductive cells (spores of the fungus Histoplasma capsulatum. Float in the air when dirt or other material is altered.

The fungus thrives in moist soil, rich in organic matter, especially the feces of birds and bats. It is especially common in the chicken and pigeon coops, old barns, caves, and parks.

Histoplasmosis is not contagious, so it cannot be transmitted from person to person. If you've had histoplasmosis, you can get again. However, if you get it again, the disease is likely to be more mild the second time.

Risk factors

The possibilities of development of histoplasmosis symptoms increase with the number of spores inhaled. People are more likely to be exposed include:

  • Farmers
  • Pest control workers
  • Breeders of poultry
  • Construction workers
  • Roofers
  • Landscapers and gardeners
  • Cavers
  • The demolition of workers

Increased risk of serious infection

Children under 2 years of age and adults aged 55 years and older have weaker immune systems. Because of this, they are more likely to develop disseminated histoplasmosis — is the most severe form of the disease. Other factors that can weaken your immune system include:

  • human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS)
  • Cancer chemotherapy
  • Corticosteroids, such as prednisone
  • The tumor necrosis factor inhibitors, are often used for the control of rheumatoid arthritis
  • Medications to prevent the rejection of organ transplants

Complications

Histoplasmosis can cause many serious complications, even in healthy people. For infants, older adults, and people with weakened immune systems, the potential problems are often deadly.

Complications can include:

  • Acute respiratory distress syndrome. Histoplasmosis can cause damage to the lungs, to the point that the air sacs begin to fill with fluid. This prevents a good air exchange and can deplete the oxygen in your blood.
  • The problems of the heart. Inflammation of the sac surrounding the heart (pericardium) is called pericarditis. When the fluid in the bag increases, this can interfere with the heart's ability to pump blood.
  • Adrenal insufficiency. Histoplasmosis can cause damage to the adrenal glands, which produce hormones that give instructions to virtually every organ and tissue in your body.
  • Meningitis. In some cases, histoplasmosis can cause inflammation of the membranes that surround the brain and spinal cord.

Prevention

It is difficult to avoid exposure to the fungus that causes histoplasmosis, especially in areas where the disease is widespread. But the adoption of the following measures can help reduce the risk of infection:

  • Avoid exposure. Avoid the projects and activities that could expose the fungi, such as the exploration of caves and breeding of birds, such as pigeons or chickens.
  • Spray contaminated surfaces. Before you dig the soil or work in an area that could harbor the fungus that causes histoplasmosis, soak it with water. This can help to prevent the spores are released into the air. The spray of the poultry houses and barns, before the cleaning can also reduce your risk.
  • Use a respirator mask. Consult the National Institute for Occupational Safety and Health to determine which type of mask provides protection for your level of exposure.

Histoplasmosis

Diagnosis

The diagnosis of histoplasmosis can be complicated, depending on what parts of the body are affected. While the test may not be required for mild cases of histoplasmosis may be crucial in the treatment of life-threatening cases.

Your doctor can suggest the search for evidence of the disease in samples:

  • Lung secretions
  • Blood or urine
  • Lung tissue (biopsy)
  • Bone marrow

Treatment

The treatment generally is not necessary if you have a mild case of histoplasmosis. But if the symptoms are severe or if you have a chronic or disseminated form of the disease, it is likely that you will need treatment with one or more antifungal drugs. If you have a severe form of the disease, you may need to continue taking medication for three months to a year.

Preparing for your appointment

It is likely to start by seeing your primary care provider, who may refer you to a specialist in infectious diseases. Depending on the symptoms and the severity of the infection, you may also see other doctors, such as a lung specialist (pulmonologist) or a heart specialist (cardiologist).

What you can do

Make a list of:

  • Your symptoms, including any that seem unrelated to the reason for which you scheduled the appointment, and when they began
  • Key personal information, including possible exposure to areas with numerous birds or bats
  • All the medications, vitamins, or other supplements you are taking, including dose
  • Questions to ask your doctor

For histoplasmosis, questions to ask your health care provider include:

  • What is the most likely cause of my symptoms?
  • How could I have gotten this infection?
  • What tests do I need?
  • I'm going to need treatment and, if so, which do you recommend?
  • What side effects can I expect from treatment?
  • I have other health conditions. How can I best manage these conditions?
  • There is printed material I can have? What sites do you recommend?

What to expect from your health care provider

Your health care provider is likely to ask questions such as:

  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • Do you work outdoors?
  • He has spent time in the areas that there are a lot of birds?
  • The time has passed in caves or in other areas where the bats could live?
Symptoms and treatment of Histoplasmosis