Histoplasmosis - Causes, Symptoms, and Treatment

Introduction:

The soil is adulterated with bird and bat droppings, and when people inhale these spores while cleaning or demolishing, they get histoplasmosis. It is common in Mississippi and Ohio river valleys. It is also seen in Africa, Asia, Australia, and Central and South America. Many people do not exhibit any symptoms, and some do not even know they are infected. But people with a weak immune system and infants develop symptoms like fever, chills, dry cough, chest pain, etc. Although mild symptoms do not require testing, severe conditions need testing the lung secretions, bone marrow testing, and lung biopsy. Individuals exhibiting minimal symptoms refrain from treatment, but those with severe infections need antifungal therapy.

What Causes Histoplasmosis?

By breathing the spores (the reproducing components of the fungus Histoplasma capsulatum), histoplasmosis results. These spores hover in the air when the soil contaminated with the fungus is disturbed. The fungus grows in damp soil, abundant in organic materials like bird or bat droppings. It is also commonly found in pigeon and chicken coops, old unused barns, caves, and parks. This fungus attacks the lungs and causes some symptoms in the infected people. It spreads to other body parts when the infection is severe. Skin lesions also develop in some patients.

What Are the Types of Histoplasmosis?

• Acute Histoplasmosis: Acute histoplasmosis or short-term is mild in form and does not cause any complications. A few people with this type do not even develop symptoms.

• Chronic Histoplasmosis: Chronic histoplasmosis or long-term is less common than acute histoplasmosis. In rare cases, the infection spreads to the whole body and becomes life-threatening if left untreated. Widespread disease is common in patients with weak immunity and areas where the fungus is commonly seen.

What Are the Symptoms of Histoplasmosis?

Histoplasmosis does not cause symptoms in most cases. However, a few symptoms may develop in people with weak immune systems and infants.

• Fever.

• Chills.

• Headache.

• Chest pain.

• Joint pain.

• Dry cough.

• Muscle pain.

• Feeling weak and tired.

• Reddish bumps in the lower part of the legs.

In severely infected patients, below symptoms mentioned will be seen.

• Excessive sweating.

• Shortness of breath.

• Blood in cough.

• High fever.

• Neck stiffness and headache due to the swelling surrounding the brain and the spinal cord.

What Are the Tests to Find Histoplasmosis?

People with mild histoplasmosis hardly require testing, but in severe infections, the doctor will recommend a few tests to confirm the diagnosis.

• Blood Tests: Blood tests are done to screen the normal ranges of the blood parameters like red blood cells, white blood cells, platelets, hemoglobin, eosinophils, neutrophils, etc. Any changes in the normal ranges of these parameters reveal an infection.

• Urinalysis: A urine test is done to check the urine's acidity, pH, and concentration. Other components like proteins, ketones, blood, bilirubin, or any evidence of infection are also screened.

• Urine Culture: A urine culture is done to check for bacteria or other infection-causing germs in the urine sample.

• Sputum Culture: Sputum is the phlegm or mucus secretions in the lungs. The sputum is checked for the growth of bacteria or any other germs that cause infection to the lungs or airways connecting the lungs.

• Blood Culture: A blood culture is performed to check for bacterial growth in the blood.

• Lung Biopsy: A lung biopsy is performed by removing a small portion of the organ to look for pathological changes in a microscopic view.

• Liver Biopsy: A small liver tissue is removed and viewed under a microscope to look for abnormalities.

• Skin Biopsy: A small part of the skin is removed to check for any abnormalities or pathological changes in the skin. It is a confirmatory test and reveals the type of skin disease.

• Bone Marrow Biopsy: Bone marrow is the soft, fatty tissue present in the center of the bones. A small portion of the bone marrow is removed and viewed under a microscope for abnormalities.

• X-ray: An X-ray uses a high-frequency radio wave to capture images of bony structures and their neighboring tissues.

• Computerized Tomography (CT) Scan: Computed tomography uses high-frequency radio waves to capture images of internal organs and structures at different angles with the help of a computer. It gives a detailed view of internal organs.

How Is Histoplasmosis Treated?

• Acute Histoplasmosis: In patients with acute histoplasmosis, the symptoms are mild and do not require treatment. However, the doctor may suggest taking over-the-counter medications for symptoms like body pain or fever.

• Chronic Histoplasmosis: Patients with an infection for more than a month or who have shortness of breath need antifungal therapy. Antifungal medications like Ketaconozole, Amphotericin B, and Itraconazole will be recommended. Medications will also be given intravenously for a speedy recovery from severe infections.

Who Is at Risk of Getting Histoplasmosis?

• Farmers.

• Pest control workers.

• People working on poultry farms.

• People working at construction sites.

• Landscapers and gardeners.

• People working at demolition sites.

• Cave explorers.

• People who build or repair roofs.

• Infants and children below two years and older adults above 55 have weak immune systems.

What Are the Complications of Histoplasmosis?

Histoplasmosis becomes life-threatening if the infection is left untreated. In addition, certain complications occur in those cases.

• Heart Dysfunction: The inflammation surrounding the heart cannot function properly.

• Acute Respiratory Distress Syndrome: If the lungs are filled with water, acute respiratory distress syndrome develops and progresses to reduced blood oxygen levels.

• Meningitis: It is the swelling of the membranes around the brain and spinal cord.

• Hormonal Issues: Histoplasmosis sometimes damages adrenal glands leading to hormonal imbalances.

How to Prevent Histoplasmosis?

• The risk of exposure to histoplasmosis can be prevented by avoiding places like caves, parks, old abandoned barns, cleaning, and demolition sites.

• Spraying the area with water that needs cleaning or digging to avoid the spread of soil in the air.

• Using breathable masks while cleaning or working at demolition sites.

Can Histoplasmosis Recur?

Histoplasmosis can recur, and the severity will be less. The initial contact with the infection may have caused troublesome symptoms, but when contracting the infection a second time, the symptoms become milder.

Conclusion:

Histoplasmosis occurs while inhaling fungal spores that hover in the air when a contaminated area with bat or bird droppings is disturbed. The symptoms may appear from mild to severe. A few people will be aware of the infection, as some do not show any symptoms. However, the symptoms may be moderate to severe, with chest pain, headaches, shortness of breath, joint pain, and red skin lesions in people with weak immune systems. The treatment usually involves antifungal medications for a few days to a few months, depending on the severity of the condition. For milder cases, treatments are not required, and they resolve over time. However, visiting the doctor when mild symptoms develop may reduce the risk of complications and can improve the patient's quality of life.