What is it?

Histoplasmosis Care Guide

Histoplasmosis (his-toh-plaz-MOH-sis) is an infection (in-FEK-shun) of the lungs caused by a fungus (germ). Sometimes it can spread to other organs of the body. You may need to use medicine to treat histoplasmosis, or you may not need any treatment. Most people who have histoplasmosis feel better after treatment. If a serious histoplasmosis infection is not treated, it could lead to long-term health problems or death. People usually begin to have signs and symptoms three to 17 days after being exposed to histoplasmosis.

What causes histoplasmosis?

Histoplasmosis is caused by breathing fungus-filled air into your lungs. The histoplasmosis fungus comes from soil that has bird or bat droppings. The fungus may live in chicken houses, lofts, chimneys, attics, or caves. Histoplasmosis is common in the soil in some parts of the United States such as the Ohio River Valley and the Mississippi River Valley. It is also found in Mexico, and Central and South America. Sometimes the fungus is carried on the wind to other places. The fungus is too small to be seen in the air. Histoplasmosis cannot be spread from one person to another.

What are the signs and symptoms of histoplasmosis?

  • Some healthy people have no signs and symptoms of a histoplasmosis infection. When healthy people have signs and symptoms, they are usually mild and last two to three weeks. Mild signs and symptoms include fever, chills, and fatigue (tiredness). They also include headaches, chest pain, and a dry cough.

  • Histoplasmosis may be more serious in babies, young children, and older adults. It can be more serious in healthy people who inhale (breathe in) a large amount of histoplasmosis fungus. Histoplasmosis can be very serious for people who have another disease affecting the body's ability to fight infections. Examples of these diseases are HIV, AIDS, cancer, or long-term lung problems such as emphysema. It may take much longer for these people to get better. Signs and symptoms of a more serious histoplasmosis infection are the following:

    • Chronic (long-term) fever.

    • Difficulty (trouble) breathing.

    • Enlarged (swollen) lymph nodes. Lymph nodes are the body's garbage (waste) disposal system. Lymph nodes are small sacs that hold waste until the waste can drain out of the body. You may also have an enlarged liver or spleen (body organs inside your belly).

    • Extreme fatigue.

    • Joint and muscle pain.

    • Night sweats.

    • Painful red lumps on the arms or legs.

    • Problems with your blood such as anemia (ah-NEE-mee-uh) and bruising. Anemia is a condition where you have fewer red blood cells to carry oxygen to your body. You may also have a low number of white blood cells. White blood cells help your body to fight infection.

    • Weight loss.

How is histoplasmosis diagnosed?

Your caregiver will do a medical exam and will ask you questions. Tests may be done to help your caregiver learn why you are sick. You may need a chest x-ray. This test shows a picture of your heart and lungs. The caregiver may draw blood or ask you to give a sample of urine and sputum (spit). These are sent to the lab for testing. If the histoplasmosis is making you very sick, your caregiver may do a biopsy. During a biopsy, a sample of your body tissue is taken and sent to a lab for tests. For example, tissue may be taken from your lymph nodes, skin, lungs, bone marrow, or liver.

How is histoplasmosis treated?

Treatment will depend on your health, test results, and how sick the histoplasmosis has caused you to be. Most infections in healthy people do not need treatment. If you have a more serious histoplasmosis infection you may need one or more of the following medicines:

  • Antifungal medicine: This medicine kills the fungus causing your infection. Some medicines cannot be taken with antifungal medicines. Tell your caregiver if you are taking other medicines, vitamins, herbal, or food supplements. You may need to take antifungal (an-ti-FUNG-gal) medicine for a long time. Do not stop taking antifungal medicine unless your caregiver tells you to. If you are pregnant or trying to get pregnant, talk to your caregiver before taking any antifungal medicine.

  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your primary healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.

  • Fever medicine: This medicine helps to lower a high body temperature (fever). The fever may be from your infection or from your antifungal medicine.

  • Steroids: Steroids (STER-oids) decrease redness, pain, and swelling caused by your infection or your antifungal medicine.

  • Anti-itching medicine: Caregivers may give you this medicine to keep your skin from itching. Your skin may itch from your antifungal medicine.

  • Anti-nausea medicine: Caregivers may give you this medicine to control vomiting (throwing up) from your antifungal medicine.

How do I keep from getting histoplasmosis again?

The most important way to keep from getting histoplasmosis again is to avoid places where the histoplasmosis fungus grows. This includes bat caves, chicken houses, and mushroom cellars. If you must work around any of these places, wear a mask over your mouth and nose to keep from breathing in histoplasmosis fungus. If you will be working in the soil, sprinkle it with water before you begin working. This may allow less dust to be released into the air around you. Certain people, such as people who have AIDS, are more likely to get histoplasmosis a second time. These people may be asked to take medicine for months or years to keep from getting histoplasmosis again.

What are the risks in having histoplasmosis?

If a severe histoplasmosis infection is not treated, it may lead to serious health problems. Histoplasmosis may spread and cause inflammation in the heart lining and brain. It may spread to other body areas such as the abdominal (belly) organs, glands and skin. It may cause the lymph nodes inside your chest to become hard. These hard lymph nodes may erode (eat through) the tissue of your esophagus or bronchi. Your esophagus is the tube that connects your mouth to your stomach. The bronchi are airway tubes leading to the lungs. You may need surgery to fix the tissue damage caused by histoplasmosis. Histoplasmosis may cause you to have long-term breathing problems and joint pain. It may cause shock, kidney and liver failure, or even death.

Call your caregiver if:

  • You have a fever, chest pain, and a dry cough. Call if you have these and other signs of histoplasmosis three to 17 days after working in soil or being around bird or bat droppings. This includes spending time in chicken houses, lofts, chimneys, attics, caves or other places with many bats or birds.

  • You feel like you are getting sicker, or you do not think your antifungal medicine is working.

  • You have questions about histoplasmosis or your medicines.

Seek care immediately if:

  • You have trouble breathing or begin coughing up blood.

  • You become confused or cannot think clearly. Call if you begin having seizures (convulsions).

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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