Histoplasmosis

The Histoplasmosis is an infection with the mold Histoplasma capsulatum, which can affect the entire body, but is mostly restricted to the lungs. This disease is rare in Europe. Distribution areas are especially Africa, Indonesia, South, Central and partly North America.

What is histoplasmosis?

The causative agent of Histoplasmosis is a dimorphic fungus called Histoplasma capsulatum. Dimorph means that it can occur both in the mycelial form as a mold and in the form of individual cells as a yeast fungus.

Its appearance depends on the temperature. The mold form is at 25 degrees and the yeast form at 37 degrees (body temperature). With appropriate exposure to this fungus, anyone can develop histoplasmosis, although people with healthy immune systems usually do not develop any symptoms.

Only for immunocompromised people, e.g. B. in AIDS, the pathogen is often spread over the entire body with often fatal course of the disease. In the distribution areas of this fungus, histoplasmosis is considered the defining symptom of HIV.

causes

Histoplasmosis is caused by an infection with the fungus Histoplasma capsulatum. Infection often takes place in bat caves or chicken coops.

It is transmitted through dust and becomes lodged in the lungs. The so-called macrophages (scavenger cells) become active immediately and surround the fungal cell. However, the fungus is not killed in this phase. On the contrary, it can reproduce further within the phagocytes by sprouting. Since it appears as a yeast fungus in the form of a single cell at body temperature, it can reach the entire body with the macrophages via the bloodstream.

In people with an intact immune system, the pathogens are killed in a further phase of the immune reaction. In over 90 percent of cases, there are no symptoms and lifelong immune protection against Histoplasma capsulatum is built up. On the other hand, immunocompromised people often develop severe disease courses with histoplasmosis, some of which are fatal.

Symptoms, ailments & signs

In about 90 percent of cases, infection with Histoplasma capsulatum does not cause any symptoms. In individual cases, small scars in the area of ​​the lungs can be detected during the X-ray examination. Symptomatic patients suffer from symptoms such as a dry cough, weakness and general cold symptoms. In addition, severe stomach pain with vomiting can occur.

In the course of the disease, fever and chills also develop, combined with sweat attacks and severe stomach pain. The initial symptoms usually appear within 3 to 14 days after contact with the fungus. If the histoplasmosis progresses, weight loss can occur.

Symptoms such as weakness, shortness of breath and chest pain can also occur. If the eyes are involved, visual disturbances occur. A severe course manifests itself as spotty areas in the lower area of ​​the lungs. Other symptoms may occur in people with weakened immune systems.

Corresponding risk groups suffer from headaches, cramps and injuries in the oral cavity in addition to the histoplasmosis symptoms. In the absence or inadequate treatment, infection with Histplasma capsulatum can lead to death of the patient. Depending on the form of the disease, other symptoms of the brain, nervous system, or skin may occur.

Diagnosis & course

Due to the rarity of one Histoplasmosis misdiagnosis is common in Europe. Although the disease is mostly silent, it can lead to severe symptoms in the event of an infection with a high concentration of fungal spores or a weak immune system, which are manifested by pain when inhaling, fever, chills and coughing.

You may also experience a bloody cough, wart-like lumps on the skin, and swollen lymph nodes. A suspected diagnosis is made by ascertaining the circumstances of the illness and by excluding other illnesses. If the suspicion of histoplasmosis is confirmed, the fungus Histoplasma capsulatum can be detected by skin swabs, a biopsy of the lungs and blood or spinal cord examinations.

Imaging techniques reveal shadows on the lungs created by calcified lumps. Antibody detection is mostly unreliable in histoplasmosis, because people with weak immune systems do not show adequate immune reactions.

Complications

Histoplasmosis leads to severe discomfort and complications in the area of ​​the lungs and airways. In most cases, the affected person initially feels sick and exhausted and suffers from a high fever. Furthermore, pneumonia and a dry cough develop. The cough can also develop into a coughing up blood, which can usually lead to anxiety or panic attacks.

The patient's immune system is severely weakened and further infection or inflammation can occur. The usual symptoms of the flu also occur, so that the patient's resilience is extremely reduced. People also become underweight and, in many cases, become dehydrated. The patient's quality of life is greatly reduced and restricted by the histoplasmosis.

Direct treatment is not necessary in every case. The histoplasmosis often heals on its own and there are no further complications. If the patient has previously suffered from a weakened immune system, treatment is carried out with the help of medication. If left untreated, histoplasmosis can lead to death in the worst case if the person affected is also infected with HIV, for example.

When should you go to the doctor?

If the person concerned suffers from breathing difficulties, a doctor should be consulted. If there are no other colds or allergic reactions, breathing restrictions are considered worrying and must be clarified. There is an undersupply of the organism, which in the long term leads to a life-threatening condition. Consult a doctor if you feel uneasy, or if you feel sick or if you feel generally weak.

Fatigue, exhaustion and a decline in normal performance are signs that must be carefully examined and treated. If the symptoms increase or if they spread further in the body, a visit to the doctor is essential. If the person concerned suffers from pain when inhaling, special care is required. If you see this warning, you should see a doctor as soon as possible so that no further damage occurs. Sleep disorders, palpitations, high blood pressure and abnormalities in the heart rhythm should be examined by a doctor.

Swollen lymph nodes unrelated to the flu are especially uncommon if they have been present for several weeks. Signs such as chills and severe unwanted weight loss also require a doctor's visit. A slow increase in the symptoms described is an indication of the fungal disease. The sufferer experiences a gradual deterioration in their well-being and should see a doctor as soon as the changes lead to restrictions on their daily obligations.

Doctors & therapists in your area

Treatment & Therapy

A therapy of Histoplasmosis is usually not necessary due to the minor symptoms. People with an intact immune system can experience acute symptoms as a result of an infection with a high concentration of pathogens, but the disease heals completely after seven to eighteen days.

In contrast, immunocompromised people often develop the chronic form of histoplasmosis, whereby the pathogens are not completely destroyed. Chronic histoplasmosis can then change into the disseminated form with serious symptoms, which, if left untreated, lead to over 90 percent death. However, if disseminated histoplasmosis is treated, the lives of over 85 percent of patients can be saved.

In the chronic or disseminated course of the disease, antimycotics (antifungal agents) must be treated for several weeks. If foci of pus have formed in the body, surgical removal is indicated. People with a chronically weakened immune system (HIV) must be treated permanently with antimycotics for histoplasmosis.

Outlook & forecast

The prognosis for histoplasmosis is linked to the general health of the patient. With a stable and healthy immune system, the prognosis is favorable. The pathogens can be killed by the body's own defense system. This prevents them from spreading and the fungal spores are transported out of the organism via the natural human excretion system. In addition, the body develops an immunity to the pathogens so that the person affected is adequately protected from renewed infestation of the fungal spores for life.

In most cases, people who have a weakened immune system have a worse prognosis. The risk group includes infants, children, the elderly or the chronically ill. With them, the body's own defense system is not yet fully developed or is not functional due to other disorders. This means that the pathogens can be killed more difficult or not at all. In addition, they can multiply and spread further without significant resistance.

If there is no comprehensive medical care, the general health of the person concerned deteriorates within a short time. In addition, other diseases can develop, since the organism is generally susceptible to germs, bacteria or other fungi. The prospect of a cure in these people depends on the progression of the disease and the ability to adequately support the immune system.

prevention

To prevent a Histoplasmosis should be in a risk area z. B. when visiting a bat cave face mask be worn. People with weakened immune systems can inhale antifungal drugs prophylactically or take certain antibiotics. Even healthy people who have already built up immunity to histoplasmosis should not expose themselves to the pathogens in massive form.

Aftercare

In most cases, those affected with histoplasmosis have no special and direct options and measures for follow-up care. This disease must primarily be examined and treated by a doctor so that there are no further complications or further worsening of the symptoms. Histoplasmosis can only be treated with early detection of the symptoms.

The disease can be fatal if left untreated. In most cases, drugs are used to treat histoplasmosis. It is important to ensure that the drugs are taken regularly and, above all, that they are taken correctly. If anything is unclear or if you have any questions, a doctor should always be consulted first.

Possible interactions or side effects of the medication must also be considered. The lungs must also be spared during histoplasmosis. Exertion or stressful and physical activities should be avoided in order to avoid unnecessary strain on the lungs.

Smoking should also be avoided, although a healthy lifestyle can generally have a very positive effect on the further course of this disease. Contact with other people affected by histoplasmosis can also be useful, as it is not uncommon for information to be exchanged.

You can do that yourself

Histoplasmosis can be avoided through strict hygiene measures. If the person concerned is in a risk area, a face mask must be worn, for example. In general, the disease can be avoided by avoiding exposure to the causative agents of histoplasmosis.

If the patient suffers from a weakened immune system, antibiotics can be taken as a precaution to avoid an outbreak of the disease. In the case of a serious illness, however, treatment by a doctor is always necessary, as the illness can otherwise lead to the patient's death. Patients have to take care of their bodies during the treatment and not subject them to unnecessary stress. Bed rest is recommended, with the person affected being looked after by friends or relatives. In the case of pneumonia, various home remedies such as teas or milk with honey can be used to protect the throat and counteract the cough.

In the event of panic attacks or anxiety attacks, a doctor should always be sought. As a rule, the doctor can calm the patient down and explain the consequences of the disease. Conversations with other histoplasmosis patients can also have a positive effect on the disease.