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Histoplasmosis is a common fungus from around the globe. It is clinically silent in 95 percent of cases but it is a disease you do not want to miss the signs of because it will get a much harder treat once it spreads throughout your body.

As we have seen on our investigative road of suspicious densities on the lungs already, an irregularity on your chest X-ray can point in the direction of many possibilities. Of course, we need to ensure that it is not a lesion for lung cancer but once that has been ruled out, there are still numerous possibilities. It could be a sign of bronchitis or asthma or even an opportunistic infection like tuberculosisViruses and bacteria are the most likely types of infections but there is another category of infections that you cannot forget about in the hospital wards. Those would be fungal infections. Histoplasmosis infections represent one common type of fungal infection that you could contract with very specific symptoms. Here, we will cover the signs of histoplasmosis that you cannot miss. 

What is Histoplasmosis? 

Arguably, Histoplasmosis is one of the most common types of mycosis fungal infections in the United States. Thankfully, it is relatively rare compared to other diseases that could be possible but investigations show that more than half of the states in the United States have reported cases of Histoplasmosis. The states involved most are concentrated in the Ohio and Mississippi River Valleys. Bird and bat droppings are the most common source of infection with this type of fungal infection so if you are an enthusiast of spelunking, or cave exploring, you are at a much higher risk of contracting the disease. [1] Don't think that reading this from outside of the United States makes you safe from this fungus, however. Tropical areas around the globe are perfect breeding grounds for this pathogen [2]. 

After traveling to a tropical region, patients with an acute infection of Histoplasmosis will typically present with symptoms of shortness of breath and a chronic dry cough. This is a type of infection that will typically resolve on its own within a few as long as you have the acute form. [3] Chronic infections will be much harder to diagnosis and patients will suffer from a long history of coughing and dyspnea [4]. In roughly 95 percent of infections, however, if you are healthy without any additional medical problems, you will not have any noticeable symptoms [5]. That is until you have a drop in your immune system when this disease can resurface and make a problem even more severe. 

When a patient comes to the hospital, a doctor will need to order a chest X-ray in order to get a better look at what is going on. A chest X-ray will reveal multiple nodules on the lungs, a widened mediastinum and the upper lobes of the lung can collapse on themselves. Initially, doctors may think that this is a sign of a type of lung cancer. [6] A bronchial lavage will be needed to take a biopsy of the lungs when histopathology will show a fungal infection. 

How Do You Treat It? 

Once this disease is inside of you, it will be very similar to a disease like tuberculosis. You will not have symptoms at the onset if you are a healthy individual and the disease will silently spread throughout your body. This is the process referred to as dissemination in medicine. Once you have a weakened immune system, you can not only have symptoms involving your lungs but have symptoms like chronic fevers, oral ulcers and it can even get into your bones if you do not treat it quickly. [7]

At this stage, the signs of Histoplasmosis are even harder to read so patients may have a frustrating course to tread as they wait for doctors to give a conclusive diagnosis of the disease. Once diagnosed, you need to begin treatment immediately. Itraconazole is the anti-fungal drug that you will need for this disease if you are healthy. If you have an immune deficiency like HIV, Amphotericin B would be a better option for you. 

In one study done to determine the effectiveness of the drug, patients were given Itraconazole for a period of 3 months. In 50 of 59 cases, patients responded to therapy. It took between 3 and 6 weeks for patients to begin to notice a resolution of symptoms once this drug began. [8] Even though is this a drug that is quite helpful, what may make patients stop the disease would be because of the toxicity. It can be quite dangerous for the heart and can actually lead to heart failure if it is not stopped. [9]

All in all, this rather innocent appearing fungus can become quite bothersome if you do not take proactive measures. If you travel to endemic areas of this infection, it is wise to test yourself with plasma testing and a chest X-ray in order to make sure you are free of any suspicious densities on your lungs that could point towards Histoplasmosis

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