Histoplasmosis is a respiratory and blood-borne disease caused by a fungus called Histoplasma capsulatum. It can be a chronic condition and often starts with an initial infection that shows no symptoms. The symptoms of histoplasmosis are similar to those of pneumonia or other chronic illnesses. Diagnosis is usually done by identifying the organism in sputum or tissue samples, or by using specific serum and urine antigen tests. Treatment, if necessary, typically involves the use of antifungal medications such as amphotericin B or azoles.
Most cases of histoplasmosis are either asymptomatic or have mild symptoms, which means that patients may not seek medical attention. However, in some cases, histoplasmosis can present as an acute primary infection with symptoms like fever, cough, muscle pain, chest pain, and general fatigue. In these cases, acute pneumonia may develop and can be detected through physical examination and chest x-rays.
Another form of histoplasmosis is chronic cavitary histoplasmosis, which is characterized by pulmonary lesions that resemble cavitary tuberculosis. Symptoms include a worsening cough and shortness of breath, which can eventually lead to respiratory dysfunction. Unlike other forms of histoplasmosis, dissemination does not occur in chronic cavitary histoplasmosis.
Progressive disseminated histoplasmosis is a more severe form of the disease that affects multiple organs. It is characterized by involvement of the reticuloendothelial system, resulting in hepatosplenomegaly (enlargement of the liver and spleen), lymphadenopathy (swollen lymph nodes), and sometimes oral or gastrointestinal ulcerations. The symptoms of progressive disseminated histoplasmosis are often nonspecific and subtle, including fever, fatigue, weight loss, weakness, and malaise. In patients who are HIV-positive, the condition may worsen without clear reasons. The central nervous system can also be affected, leading to meningitis or focal brain lesions. Although rare, adrenal infection can cause Addison disease. Severe pneumonia is also rare but can occur in patients with AIDS, resulting in hypoxia, hypotension, mental status changes, coagulopathy, or rhabdomyolysis.
Fibrosing mediastinitis is a chronic and rare form of histoplasmosis that can cause circulatory problems. It is believed to be caused by an excessive immune reaction to the persistent presence of nonviable fungal antigen, leading to scarring and obstruction of blood vessels or airways in the mediastinum.
In some cases, histoplasmosis can affect vision, but the organisms are not found in ocular lesions. Antifungal chemotherapy is not effective for ocular histoplasmosis, and the link between ocular lesions and H. capsulatum infection is unclear.
To diagnose histoplasmosis, various tests may be necessary. These include bronchoalveolar lavage or tissue biopsy to obtain histology specimens. Serologic testing and culture of urine, blood, and sputum samples are also commonly done. It’s important to inform the laboratory if histoplasmosis is suspected because culturing the fungus can pose a biohazard to the personnel.
Microscopic histopathology can strongly suggest the diagnosis, especially in patients with AIDS and extensive infections. In these cases, intracellular yeasts may be visible in blood samples stained with Wright or Giemsa. Fungal culture is used to confirm the diagnosis of histoplasmosis. Lysis-centrifugation or culture of buffy coat specimens can improve the yield from blood samples. DNA probes are also available to rapidly identify the fungus once it has grown in the laboratory.
A test for H. capsulatum antigen is sensitive and specific, particularly when serum and urine samples are tested simultaneously. The Histoplasma antigen is present in the serum of 80% of patients with disseminated histoplasmosis, and it is present in the urine of over 90% of these patients. However, there is a possibility of cross-reactivity with other fungi such as Coccidioides immitis, Blastomyces dermatitidis, Paracoccidioides brasiliensis, and Penicillium marneffei.
In most cases, acute primary histoplasmosis resolves on its own without treatment. However, in very rare instances, death can occur after a severe and widespread infection.
If you suspect you have a problem with histoplasmosis or need assistance with cleaning and sanitizing bird droppings, nests, or related issues, please feel free to contact us at hello@khunclean.com or call us at [082-797-3702]. Our team at Bird Poop Cleaning will be happy to assist you.