Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. Symptoms of this infection vary greatly, but the disease affects primarily the lungs. Occasionally, other organs are affected; called disseminated histoplasmosis, it can be fatal if left untreated. Histoplasmosis is common among AIDS patients because of their suppressed immunity. In immunocompetent individuals, past infection results in partial protection against ill effects if reinfected. Histoplasma capsulatum is found in soil, often associated with decaying bat guano or bird droppings. Disruption of soil from excavation or construction can release infectious elements that are inhaled and settle into the lung. From 1938 to 2013 in the US, 105 outbreaks were reported in a total of 26 states plus Puerto Rico. In 1978 to 1979 during a large urban outbreak in which 100,000 people were exposed to the fungus in Indianapolis, victims had pericarditis, rheumatological syndromes, esophageal and vocal cord ulcers, parotitis, adrenal insufficiency, uveitis, fibrosing mediastinitis, interstitial nephritis, intestinal lymphangiectasia, and epididymitis. Histoplasmosis mimics colds, pneumonia, and the flu, and can be shed by bats in their feces. Signs and symptoms
If symptoms of histoplasmosis infection occur, they start within 3 to 17 days after exposure; the typical time is 12–14 days. Most affected individuals have clinically silent manifestations and show no apparent ill effects. The acute phase of histoplasmosis is characterized by nonspecific respiratory symptoms, often cough or flu-like. Chest X-ray findings are normal in 40–70% of cases.
Positive Histoplasmin skin tests occur in as many as 90% of the people living in areas where H. capsulatum is common, such as the eastern and central United States.In Canada, the St. Lawrence River Valley is the site of the most frequent infections, with 20–30% of the population testing positive. A review of reported cases in 2018 showed disease presence throughout Southeast Asia, In India, the Gangetic West Bengal is the site of most frequent infections, with 9.4% of the population testing positive. H. c. capsulatum was isolated from the local soil proving endemicity of Histoplasmosis in West Bengal. History
Histoplasma was discovered in 1905 by Samuel T. Darling, but only in the 1930s was it discovered to be a widespread infection. Before then, many cases of histoplasmosis were mistakenly attributed to tuberculosis, and patients were mistakenly admitted to tuberculosis sanatoria. Some patients contracted tuberculosis in these sanatoriums. Society and culture
Johnny Cash included a reference to the disease, even correctly noting its source in bird droppings, in the song "Beans for Breakfast". Bob Dylan was hospitalized due to Histoplasmosis in 1997, causing the cancellation of concerts in the United Kingdom and Switzerland. In episode 21 of season three of the television series House M.D., a patient was diagnosed with Histoplasmosis. In episode five of season one of the television series Dexter, Vince Masuka gets worried about getting Histoplasmosis from the dust in the air and the hair of the rats.