4 key things to know about lung infections caused by fungi

Some fungi that can cause serious lung infections have retreated into many parts of the United States. A Science News Some extended range Histoplasma, Coccidioides and Blastomyces hit the nerve with a lot of readers (SN: 1/4/22).

They asked about the symptoms, treatments and experiences of these fungal diseases. Some, like Judy Knudsen, whose husband Jack died a Histoplasma infection 2020, also wrote to share his experiences with fungal infection. Others wanted to learn more about the fungi themselves.

I turned to Andrej Spec, a mycologist and infectious disease professor at the Washington University School of Medicine in St. Louis, whose team published the new maps, for answers.

Spec and colleagues are studying what fungi spread and the factors that contribute to sick people. Those changes include climate, weather patterns, extreme weather events like fires and floods, and even animal migrations.

How do you get these fungal infections?

Humans are usually infected by ingesting fungal spores during the normal life cycle of the fungus. Human activities that disturb the soil where these fungi typically live — such as agriculture, horticulture, construction, road work or archeology — can also stir up dust and spores.

In addition to soil, bird droppings and bat guano can be sources Histoplasma Fungi can infect bats and grow in the intestines of animals. Birds do not usually carry the fungus because the body temperatures of birds are usually around 39° Celsius to 42° C (102° Fahrenheit to 107° F). “They are too hot” Histobut the droppings grow a fungus, says Spec.

The greatest danger to humans comes when bird and bat droppings dry out. “People will try and sweep” [the droppings]and then you will kick and suck up all that dust.’ Instead of sweeping, Spec recommends lowering the hose and pushing it.

A person wearing a mode of exposure can be helped. “Especially if you’re immunosuppressed, wear a mask.”

It is possible to cut or scrape off the fungus and cut it into the skin, but these cases are very rare, says Spec. And generally, people cannot pass the infection on to others, except in the rarest of cases, in which an infected organ or body has infected another body, he says.

What happens in the body?

These three types of fungi are known as dimorphic fungi because they have two forms. There are molds in the soil where they usually grow. But at 37° C – the temperature of the human body – they form a transmigration into yeast, which can grow faster and spread more easily into the body.

When a person inhales fungal spores, the fungi can infect the lungs where the conditions are right to transform. People with healthy immune systems may have no symptoms or develop mild flulike symptoms, including fever, cough, fatigue, chills, and body aches. People with coccidiomycosis – the disease through Coccidioides – it can also be random on the legs or the top.

Symptoms may take time to appear. People with histoplasmosis – the disease through Histoplasma – symptoms develop between three and 17 days after exposure. Symptoms of coccidiomycosis — also known as Valley Fever — appear between one and three weeks after breathing in the spores. But it can take three weeks to three months for blastomycosis-caused Blastomyces – start signs.

Mild cases usually clear up on their own within a few weeks to a few months. But some people may have long-lasting symptoms, especially if the infection becomes severe.

In 2019, more than 20,000 people in the United States were diagnosed with coccidiomycosis, 1,124 people had confirmed or probable cases of histoplasmosis and 240 cases were confirmed or probable blastomycosis, according to cases reported to the US Centers for Disease Control and Prevention. It’s probably an undercount, since mild cases likely go unreported and infections can easily be misdiagnosed as more common lung diseases, researchers say. However, more than half of the reported cases were hospitalized with diagnoses of histoplasmosis and blastomycosis. About 5 percent of histoplasmosis patients died. So did 9 percent of those with blastomycosis.

Some severe or long-term peripulmonary diseases may develop. And in a minority of people, the infections spread to other parts of the body. Histoplasma It likes to go after our liver and spleen, our bone marrow … our glands … and our intestines,” says Spec.

Blastomyces it tends to the bones and frame. It can also spread to the brain, where it can cause an abscess.

Coccidioides spread in a similar fashion Blastomycesaffecting the bones, joints, skin and brain. But instead of creating brain abscesses, fungi cause meningitis, an inflammation of the membranes around the brain and spinal cord.

“It is with you forever if it spreads through your brain,” Spec. “You can’t drive away” Cooked. Doctors can manage the brain infection with antifungal medications and other medications to help with symptoms.

Antifungal medications can clear up most other infections. “If it’s caught early, most people do very well,” he said.

Who is most affected by these fungal diseases?

People who have weakened immune systems are more likely to develop symptoms and have a serious illness.

Both fungal infections and disease occur more often in men than in women. About 70 percent Blastomyces infection, 52 percent of Coccidioides cases and 56 percent of * Histoplasma infections in males, a 2019 CDC survey found.

Why males are more affected is not entirely clear. Some people are of the opinion that people tend to have more jobs and hobbies, which would expose them to dirt and thus fungi more.

How Jack Knudsen became infected is not clear. “We have no earthly idea why this happened,” said Judy, 82, of Oklahoma City. Already battling chronic lymphocytic leukemia, heart problems and diabetes, Jack’s immune system wasn’t up to the challenge of the fungus. “He’s excited,” he said.

He spent two weeks in the hospital on intravenous antifungal medicine. He also took four cups a day of an antifungal drug called itraconazole for the rest of his life. He died on January 23, 2019, at the age of 79. “We had a good 61 years,” says Judy.

There may be biological reasons for the male-female skew. A recent study found that a sex difference in coccidiomycosis is also present in non-human primates and in dogs. There was little difference between occupational exposures and recreational activities between male and female sea animals, says Spec, who was not involved in the study.

The researchers found no difference in the amount of weight in men up to the age of 19. After this the infection rate of the males held steady. But the woman’s infection dropped, Ian McHardy, a microbiologist and immunologist at Scripps Health in San Diego, and colleagues reported in March 2022. Open Forum Infectious Diseases. This means that estrogen and other hormones, which are usually higher in women, can protect against fungal infections. But that page is still speculation.

Interestingly, people of Filipino or African heritage may have an increased risk of more severe forms of Valley Fever. The cause is unknown. Others, including those who are pregnant, living with HIV/AIDS or have weakened immune systems from other causes, are also at higher risk of more severe disease from all three fungi. So are diabetics and the elderly.

How do I find out if my infection is caused by a fungus?

Because the symptoms of fungal infections so closely resemble other diseases, the diagnosis of fungal disease can be easy, says Spec.

Jack Knudsen started looting in 2018, Judy says. At first, the doctors thought that he had epilepsy, but the medication to treat the disorder did not have an effect. When one part of his face began to fall off, an MRI and other tests revealed that Jack had Histoplasma in his brain. “I’ve never heard that in my life,” says Judy, who said she wanted to share her husband’s story of being aware of the disease.

A blood or urine test can be used to diagnose a fungal infection. Chest X-rays or CT scans may also be used. In some cases, doctors may need a small amount of body tissue or fluids to perform the test.

“A lot of people think they have” [a fungal infection] “Probably don’t have it.” Spec, he says. “The disease is certainly more common than humans, but still relatively rare.”

People who are concerned that they may have a fungal infection can visit mycoses.org, where Spec and colleagues have put together interactive maps of where fungi are found. “You will be able to see” [based on] Where you live, you are the only one in danger. Once you have that information, your best bet is to talk to your doctor about getting tested.

Any doctor can order the test, but infectious diseases experts have more expertise with fungal diseases, he says.