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Histoplasmosis Symptoms, Causes and Risk Factors

Most histoplasmosis infections resolve by themselves. However, the three common symptomatic forms of histoplasmosis that require antifungal therapy are:

  • Acute histoplasmosis
  • Chronic cavitary histoplasmosis
  • Disseminated histoplasmosis

What Are the Symptoms of Histoplasmosis?

Acute histoplasmosis appears 2 to 4 weeks after exposure or earlier if the exposure is heavy. The most common symptoms of acute histoplasmosis are:

  • Fever and chills, flu-like illness
  • Headaches
  • Muscle pain
  • Loss of appetite
  • Shortness of breath
  • Dry cough
  • Chest pain
  • Fatigue

Most symptoms resolve in few weeks. If the exposure is very heavy, your condition may worsen into respiratory failure which may be life-threatening.

The most common symptoms of chronic histoplasmosis are:

  • Cough that is productive of thick yellow sputum
  • Shortness of breath
  • Feeling run-down or tired
  • Low-grade fever
  • Night sweats
  • Weight loss

Patients with emphysema may develop a slowly progressive form of histoplasmosis that resembles tuberculosis, except that it is not contagious. If left untreated, chronic histoplasmosis can progress with enlarging lung cavities, loss of lung function and overall clinical deterioration.

Disseminated histoplasmosis is when the infection progresses and spreads outside the lungs and throughout the body affecting multiple organs and causing severe illness. This usually occurs only in people who have a lowered immunity. The most common symptoms of disseminated histoplasmosis are:

  • Fever and chills, flu-like illness
  • Headaches
  • Shortness of breath—severe and leading to respiratory failure
  • Drop in blood pressure
  • Cough and chest pain
  • Enlarged spleen and liver
  • Gastrointestinal bleeding
  • Ulcerations in the mouth and lip
  • Bone marrow failure with decreased white and red blood cells

Disseminated histoplasmosis is life-threatening unless suspected and diagnosed in a timely fashion ensuring rapid initiation of effective antifungal therapy and supportive intensive care.

What Are Risk Factors

Anyone who lives in an endemic area may develop a mild, self-limited infection with histoplama.  The fungus usually remains in the body and never cause a problem, but if the immune system becomes depressed, it may become active again.  The following may depress the immune system and can lead to active and severe histoplasmosis

  • Recipients of solid organ transplant
  • Immunosuppressive medications
    • TNF-blockers, such as infliximab
    • Corticosteroids, such as prednisone
    • Antirejection medications, such as mycophenolate and azathioprine
  • Extremes of age (infants and the elderly.)

When to See Your Doctor
If you live in the Midwestern United States, have been exposed to activities that can cause histoplasmosis or your immune system is weak and you are have symptoms of respiratory tract infection, you should contact your doctor.

    This content was developed in partnership with the CHEST Foundation, the philanthropic arm of the American College of Chest Physicians.

    Page Last Updated: March 13, 2018

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