Symptoms and Causes
What are the symptoms of histoplasmosis?
Symptoms of histoplasmosis can include:
- Fever.
- Cough.
- Sweating.
- Shortness of breath (dyspnea).
- Chest pain.
- Headache.
- Muscle aches.
- Rash or bumps on your lower legs (erythema nodosum).
Chronic cavitary pulmonary histoplasmosis can additionally cause night sweats and weight loss. In up to 90% of people, breathing in H. capsulatum doesn’t cause any symptoms, or their symptoms resolve on their own (self-limiting).
What causes histoplasmosis?
The fungus Histoplasma capsulatum causes histoplasmosis. You get it from breathing in the mold from the soil. It grows best in soil that has bat or bird poop in it. It’s found in most parts of the world, but it’s most common in:
- The Ohio and Mississippi River valleys in the U.S. This includes states in the Midwest and South-Central U.S.
- Central and South America.
- Africa.
- Asia.
- Australia.
Most people breathe in H. capsulatum without getting sick. But some people, especially those who are exposed to a lot of fungi or who have certain health conditions, can get noticeable symptoms.
What are the risk factors for histoplasmosis?
You’re more at risk for histoplasmosis if you have a job or hobbies that can disturb large concentrations of the fungus. This includes:
- Exploring caves (spelunking).
- Farming.
- Keeping chickens or birds.
- Demolition or construction.
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You’re more at risk for severe or chronic cases of histoplasmosis if you:
- Have a weakened immune system. HIV and immunosuppressive medications are common causes of a weakened immune system.
- Have COPD or emphysema.
- Are over 55 years old or under 1 year old.
"V体育ios版" What are the complications of histoplasmosis?
Serious complications of histoplasmosis include:
- Scarring or other lung damage.
- Fibrosing mediastinitis. Fibrosing mediastinitis is scarring of the area between your lungs.
- Acute respiratory distress syndrome (ARDS).
- Central nervous system histoplasmosis. If the fungus spreads to your brain, it can cause brain swelling, headaches, confusion, impaired thinking and symptoms similar to stroke.
- Ocular histoplasmosis. If a Histoplasma infection spreads to your eye, it can cause impaired vision or vision loss.
- Spread to other parts of your body. This includes your liver, spleen, bone marrow and skin.
Diagnosis and Tests
How is histoplasmosis diagnosed?
A healthcare provider might test your blood, pee (urine), mucus from your lungs (sputum), bone marrow or a sample of affected tissue to diagnose histoplasmosis. They can use these samples to:
- Try to grow (culture) H. capsulatum. This is the best way to diagnose histoplasmosis. But this can take a long time — several weeks — and in severe cases, your provider will want to treat you before results are available.
- Look for H. capsulatum yeast.
- Test for signs of H. capsulatum in your body (antigens or antibodies).
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They’ll also use imaging like chest X-rays or CT scans to look for changes or damage caused by H. capsulatum. The specific types of test they use depends on what kind of histoplasmosis they think you have and how severe your symptoms are.
What tests are done to diagnose histoplasmosis?
In addition to imaging (like chest X-rays or CT scans), your provider may collect samples of fluids or tissues to look for signs of H. capsulatum or try to grow it over time. They can collect these fluids using:
- Urine or sputum tests. You’ll pee in a cup (urine test) or cough and spit in a tube (sputum test) to get a sample.
- Blood tests. Your provider will take blood from your arm with a needle to get a sample.
- Biopsy.Your provider will take a sample of tissue with a small incision or a needle. For a bone marrow biopsy, the provider will use a needle to take a sample from the inside of your hip bone.
- Bronchoscopy. Your provider uses a thin, lighted tube to look at the inside of your lungs. They can perform a bronchoalveolar lavage (BAL) during this procedure. A BAL “washes” small parts of your lungs with fluid. A provider collects the fluid and sends it to a lab to be tested.
VSports最新版本 - Management and Treatment
How is histoplasmosis treated? (V体育ios版)
Histoplasmosis is treated with antifungal medications if necessary. If you have mild symptoms that haven’t gone on for a long time and you’re not at high risk for serious infection, your provider may not treat you right away.
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Is there a cure for histoplasmosis?
Yes, antifungal medications can often cure histoplasmosis in people with a healthy immune system. Your provider may treat you with these medications:
- Itraconazole.
- Amphotericin B (AmB).
- Corticosteroids.
What happens if histoplasmosis is left untreated?
If you have a healthy immune system and no underlying conditions, histoplasmosis could go away on its own. But left untreated, it sometimes can spread to other parts of your body, especially if your immune system isn’t working as it should. It can cause lung damage in people with underlying lung disease.
"VSports" Outlook / Prognosis
What can I expect if I have histoplasmosis?
What to expect when you have histoplasmosis depends on how severe it is and any underlying conditions. For people with healthy immune systems and mild symptoms, your healthcare provider may “watch and wait” before treating you. If you have a weakened immune system or are very sick, you can expect to take antifungal medications for at least a year.
How long histoplasmosis lasts
Treatment lasts six to 12 weeks or longer for acute pulmonary histoplasmosis. For chronic or severe cases, you take antifungals for at least a year.
What is the survival rate of histoplasmosis?
Most people with healthy immune systems (96%) survive histoplasmosis with treatment. Some studies suggest that the mortality rate for people with a compromised immune system is between 25% and 37%.
Prevention
Can histoplasmosis be prevented?
It’s hard to avoid breathing in H. capsulatum fungus if you live in an area where it’s common. While not entirely preventable, there are some steps you can take to reduce your risk of histoplasmosis:
- Avoid areas where you’ll be exposed to dirt or dust, especially in areas where bats or birds live.
- If your job or hobbies expose you to soil that’s likely to have H. capsulatum, use an N95 respirator mask to help filter the air you breathe.
Living With (V体育ios版)
How do I take care of myself?
If you have a weakened immune system, COPD or emphysema, you should take extra precautions to reduce your risk of histoplasmosis. Ask your healthcare provider if there are specific steps you should take to protect yourself if you live in an area where H. capsulatum is common.
When should I see my healthcare provider?
See a healthcare provider if you have flu-like symptoms, cough or shortness of breath that aren’t getting better after a week or are getting progressively worse over time. Tell your provider if your job or hobbies might expose you to the fungus that causes histoplasmosis or if you’ve traveled to an area where the fungus is found.
When should I go to ER?
If you have symptoms of any kind of infection and you have a weakened immune system, talk to your provider right away or seek emergency care. Go to the nearest emergency room if you have symptoms of serious illness, including:
- High fever (over 103 degrees Fahrenheit/40 degrees Celsius).
- Severe or sudden shortness of breath.
- Chest pain.
- Coughing up blood.
- Confusion or other mental changes.
- Seizures.
- Blue skin, lips or nails (cyanosis, a sign of low oxygen in your blood).
What questions should I ask my doctor?
It might be helpful to ask a provider:
- Am I at high risk for severe histoplasmosis?
- Are there any special precautions I should take to reduce my risk of histoplasmosis?
- What symptoms should I look out for?
- When should I go to the ER?
A note from Cleveland Clinic
Histoplasmosis is a type of fungal infection in your lungs. Histoplasmosis can be hard to avoid if you live in an area where the fungus grows. Most cases aren’t serious and go away on their own. But if you have lung disease or a weakened immune system, you’re at higher risk for serious complications of histoplasmosis. You and your provider can make a plan together to protect your health and keep an eye out for any symptoms.
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Last reviewed on 03/08/2023.
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