fungi infection maybe histoplasmosis

[heartaches101]

I had a lung biposy because of a ct scan with contrast showing a nodule and inflammed lymth nodes in the top right lung.   Biopsy diagnosis was "caseating glanulomous", all I was told was that it was a fungi type infection.   That dr. has sent me back to a pulmonary doctor for futher testing.  One diisease he did mention was histoplasmosis and asked if I raised carrier pigeons.  No I don't but after I left his office later that day I remembered that I worked nine months at a office that our back room had pigeons living in the ceiling.  the ceiling being the only thing separting us and there was plenty of poo dust falling in the room.  I was in the room on a daily basis..the refrigator was in that room.   I even put gloves on and cleaned dry powder stuff off the furniture.  My question is ...on the cycle of histoplasmosis through the cbc site shows 1 is the histoplasmosis is airborne, 2 it is inhaled, 3 it involves the lung, 4 lymth node involvement, and 5 is that it goes out to other organs.   I was also told that the infection could be active or inactive.   So if I am already at the lymth node involvement stage....is my infection active?  Then again it could be a different fungi disease.....but I do live in US in the most likely zone to get histoplasmosis.

[mkh9]

From what I have read you have to have been exposed directly to the spores not the "specimen containing the spores (such as urine, spinal fluid sputum etc.) to get the disease). It has to be from bird droppings such as form pigeons, chicken dropppings such as in a chicken cage with dirt on the floor, red wing black birds, starlings, bats, grackles, cowbirds, etc. or from dirt that has spores in it and you inhale the spores directly. I think that perhaps even though most of the time Wikipedia is good, it can get some misinformation. I would read the reference to see where it came from. I will continue to look for you but I don't think if you have histo that you got it from this patient. Certain occupations can also expose to it as well. Are you always a health care worker?  or have you ever done other jobs? Histoplasma can hang around a long time before you notice symptoms. Do you have symptoms and then you went to get the CT? You have had it for a while. What is your history other than the nodule that was found?  I wonder if your friends "mouse infected house" also had bats at some point that left and when you cleaned it up the dust had the fungus in it. That sounds very suspiciuos to me. I thing that is the source actually after thinking about it.  
mkh9

[mkh9]

Hi, I just got your message and I'm sorry due to the weekend I didn't get it until today. I will write you back in a about a half hour.
mkh9

[cjhr43]

I had the same experience as heartaches 101 - CT scan with dye also showed the granulomos. My biopsy showed non-malignant nodules but I found out yesterday that I have histoplasmosis. My concern is more about how I inhaled the organism. I have no contact with birds or bats. I have been searching web info and the Wikopedia site states the disease can  be a result of human feces, vomit or urine and is still prevalent in third world countries.  I am surprised that this cause is not listed on any other site - is it incorrect? I have been cleaning up after an elderly man for four years who has frequent "accidents"... diarrhea and urine. Could this have caused my illness or would it more likely be attributed to my gardening or cleaning up my friends "mouse infested home"?

[mkh9]

Hi and thanks for keeping me up to date. I glad your cultures are negative and that the scans and so forth look negative too. You sure have had a hard time. I hope things are on the mend.
take care,
mkh9

[heartaches101]

The biopsy culttures all came back negative..which is great.  I don't know what cultures where done and am hopeful hat the Pulmonary doctor that I see next week has some insight.    guess I will find out the results for the histoplasmosis culture he started then too.   I go for the ct scan this coming Thursday to see if  either the nodule or lymph nodes have changed and then the appointment with him a week from tomorrow to get results.  

[mkh9]

I would just find out for sure if you have histoplasma. I know the culture takes a long time I just wanted to know if they did one. The biopsy usually can tell the doc if you have a fungus. So the only other one may be coccidiodes immitis. I'm not sure what else except you will want to know what the treatment will like. I know antifungal meds are hard to take but I was on one for 3 months just for toenail fungus and it didn't cause a problem. I couldn't drink alcohol because these drugs affect the liver. Try to find out if they think it is gone beyond the lungs because you have joint pain. I doubt it but it can't hurt to ask. See if they will have to do more tests to find that out. But as I mentioned neither one (histo or cocci) usually go beyond the lung. Let me know my message or back here what they say after you get back.
mkh9

[heartaches101]

Thank you so much for your reply.  The only symptoms I have is a dry cough and joint pain.  The culture isn't finish yet.  They told me it would take six weeks.  The doctor doing the surgery is returning me back to the pulmonary doctor because he only does surgery.   He said they would need to do addtional testing to determine what the fungi  infection was actually.  I go to see my new pulmonary doctor this Friday.   I have several questions to ask him.  Everyone is sending him my records because it was discoved when I had heart surgery three hours away from home.   I didn't want to have to drive the six hour round trip for test, treatment or drs. appointment.   Hope I didn't mess up.  Any questions you know of that I should be sure to ask this first visit?  I have scheduled a eye exam.  I asked if the receptist if they would be able to tell me if I had histoplasmosis and she said yes but if I did have it then I would need to be seen by a specialist. Thanks so much for your help.

[mkh9]

Hi, and sorry you may have histoplasmosis. In order to find out if you have histo is to ask the doctor that did the cultures and/or biopsy which fungus it is.
1.Yes Histoplasma is inhaled.
2.Yes it does go to the lung and the lymph nodes get activated that you have a new infection.
4. It rarely goes beyond the lung and lymph node. It does get into the blood but if you don't have lowered immunity it gets killed by your immune system. Then it will stay in the lung and you may or may not have symptoms.
5. If you have it in the lung and it is a recent infection and since your lymph nodes are swollen it probably is now causing problems from when you  inhaled it, thne you probably have an active infection. Do you have symtoms? Histoplasmosis causes pneumonia, fever, chest pain dry or non productive cough and smetimes joint pain.  It needs to be treated if you have symptoms. Also, the treatment is IV amphotericin B 1-2 weeks followed by about 12 weeks of Itraconazole.
7. Could it be a different fungi, possibly but your biopsy and culture should tell them what you have. You need to ask the doctor.
8. Yes birds and bat guano is inhaled and that is how you get it.
9. Yes Histo is in the ohio and mississippi valley areas, Kentucky, Indiana, Minnesota, illinois, and Pennsylvania.
So you really need to get treatment if you are symptomatic. Check on the culture results. It rarely goes to other organs and usually only when you are immunocompromised.
take care,