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We have a very old barn on our property that bats inhabit, so I often see large piles of bat droppings throughout the barn. We also have chickens and a chicken coop that we clean out every spring. My family and I have never gotten sick after cleaning the coop or walking through the barn, and I have never heard of histoplasmosis. After learning more about it, I will inform my family and we will take action to be more careful around these areas.

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A-C: CT scans showing lung nodules (large white circles) in patient prior to antifungal treatment. D-C: reduced size of lung nodules after antifungal treatment

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This article is a case study of an older male patient who had been on immunosuppressant drugs for several years and had been experiencing a cough for months. Lung nodules were found during scans and Histoplasma was detected after culturing. The antifungal voriconazole, which had rarely been used as treatment prior, was prescribed and taken for several weeks. After treatment, the cough had subsided and the lung nodules disappeared, and there were no negative side effects. This study shows that more antifungal drugs can be used in treatment of this infection (More).

Citation: Xie, C., Yang, Y., Wu, X., Chen, Z., Zhu, N., Song, Y., & Tong, L. (2022). A case of pulmonary histoplasmosis treated with voriconazole. Journal of infection in developing countries, 16(3), 570–574. https://doi.org/10.3855/jidc.15297

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Jaimie Mittal, MD; St. Luke's Infectious Disease Associates

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Diagnosis and Treatment of Histoplasmosis

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Diagnosis and Treatment of Histoplasmosis

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Diagnosis: Histoplasmosis is most often diagnosed through blood and urine tests that are then sent to a lab to be cultured. Physicians also use chest x-rays, tissue biopsies, travel history, and symptoms to guide their diagnosis (More).

Treatment: Because many people do not experience severe infections from Histoplasmosis, it is unlikely to be diagnosed or treated and symptoms will eventually subside on their own. However, if someone has developed a more severe infection, antifungals such as Itraconazole will be prescribed (More).

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More

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Prevention and Risk Factors for Histoplasmosis

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Prevention and Risk Factors for Histoplasmosis

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Risk Factors: The people at greatest risk for developing histoplasmosis are those who come in contact with histoplasma, such as construction workers, farmers, pest control, and other individuals working in an environment with bird and bat droppings present (More). The people at greatest risk for developing a more severe infection are those who have weakened immune systems, such as the elderly, those who are taking immunosuppressants, or infants (More).

Prevention:
1. Avoid disturbing contaminated areas of the soil or material
2. Avoid cleaning bird cages, coops, or areas where bats inhabit
3. Wear masks in contaminated areas
4. Use a professional company to remove bird and bat waste
(More)

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Symptoms and Complications of Histoplasmosis

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Symptoms and Complications of Histoplasmosis

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Although most people do not develop symptoms, and some others that have symptoms that subside without treatment, some symptoms include:
1. Fever
2. Dry cough
3. Chills
4. Headache
5. Chest pain
6. Body aches
7. Fatigue
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Some individuals may be at higher risk for a more severe infection, which can lead to any of the following complications:
1. Long term lung infection
2. Disseminated histoplasmosis: Infection spreads to brain and other areas of the body. This can be fatal
3. Weight loss and bloody cough
(More)

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Histoplasma capsulatum

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Histoplasmosis is a fungal disease caused by the fungus histoplasma capsulatum. It is found in the environment, and spores are carried through the air where they can be inhaled by humans. Because histoplasma thrives in rich soil environments, it is most commonly found in areas with bird and bat droppings, such as old barns or chicken coops. People are most likely to come in contact with the spores after agitation of the areas with droppings, such as when cleaning barns. Although inhaling the spores does not mean you will experience symptoms or be infected, for others it can lead to a severe infection (More).

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Histoplasmosis is a fungal disease caused by histoplasma.

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Histoplasmosis | Types of Diseases | Fungal Diseases | CDC

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People can get histoplasmosis after breathing in the microscopic fungal spores from the air. Although most people who breathe in the spores don't get sick, those who do may have a fever, cough, and fatigue. Many people who get histoplasmosis will get better on their own without medication, but in some people, such as those who have weakened immune systems, the infection can become severe.