Acute pulmonary histoplasmosis is a respiratory infection caused by inhaling the spores of the fungus Histoplasma capsulatum.
Causes, incidence, and risk factors
Histoplasma capsulatum, the fungus that causes histoplasmosis, is found in the Central and Eastern United States, Eastern Canada, Mexico, Central America, South America, Africa, and Southeast Asia. It is commonly found in the soil along river valleys. It gets into the soil mostly from bird and bat droppings.
You can get sick when you breathe in spores produced by the fungus. Every year, thousands of people worldwide are infected, but do not become seriously sick. Most patients have no symptoms or have only a mild flu-like illness and recover without any treatment.
Acute pulmonary histoplasmosis may happen as an epidemic, with many people in one geographical area becoming sick at the same time. In people with impaired immune systems, such as those with HIV, the disease can continue to get worse.
Risk factors include traveling to or living in the Central or Eastern United States near the Ohio and Mississippi River Valleys, and being exposed to the droppings of birds and bats. This threat is greatest after an old building is torn down, or when exploring caves. Having a weakened immune system increases your risk for getting or reactivating the disease, and for having more and worse symptoms.
Most people with acute pulmonary histoplasmosis have no or mild symptoms. The most common symptoms are:
Waht LJ, Freifeld AG, Kleiman MB, et al. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis. 2007;45(7):807-825.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.