4 Important Things To Understand About Fungal Lung Infections
Reader inquiries were sparked by news that three types of fungus are more common than previously believed.
Numerous regions of the United States now contain fungus that may lead to dangerous lung infections. Many readers were moved by a Science News article on the enlarged distribution of the fungus Histoplasma, Coccidioides, and Blastomyces.
They enquired about the signs, prognoses, and diagnostic procedures for various fungi infections. Some, such Judy Knudsen, whose husband Jack passed away in 2020 due to a Histoplasma infection, also wrote to relate their personal experiences with fungi. Some people were curious about the fungus themselves.
For clarification, I once again turned to Dr. Andrej Spec, a mycologist and specialist in infectious illnesses at Washington University School of Medicine in St. Louis, whose group produced the latest range maps.
Spec and his colleagues are researching the elements that may have contributed to the fungi’s spread as well as those that may have made individuals ill. These include alterations in the temperature, variations in the weather, severe weather occurrences like wildfires and floods, and even animal migratory patterns.
How Are These Fungi Diseases Spread?
In most cases, infection occurs when a person inhales fungal spores that are generated during a fungus’ natural life cycle. Dust and spores may also be stirred up by human activities like farming, gardening, building, road work, or archaeology that disrupt the soil where this fungus usually thrives.
Histoplasma may also be found in bird and bat guano in addition to soil. The fungus may spread to bats and develop in the intestines of the animals. Because birds’ body temperatures are normally between 39° and 42° C (102° and 107° F), they seldom carry the fungus. The fungus cannot develop in their droppings because they are “too hot for Histo,” according to Spec.
Bird and bat droppings pose the greatest danger to humans once they have dried up. People will attempt to sweep the droppings, which causes you to kick up the dust and breathe it in. Spec suggests that you “hose it down and scoop it off” rather than sweeping.
A mask may be worn to reduce exposure. “Wear a mask, especially if you’re immunosuppressed.”
Though it is very unlikely, according to Spec, the fungus might enter a wound or scrape and cause a skin infection. According to him, except in very rare circumstances where an infected individual has given an organ or other bodily part, people can’t usually spread the virus to others.
What Occurs Inside The Body?
Due to the fact that they have two forms, these three species of fungi are referred to as dimorphic fungi. They are moulds in the earth, where they often develop. But at 37° C, the temperature of the human body, they transform into yeast, which grows quickly and spreads more readily within the body.
The fungus may infect the lungs, where the circumstances are ideal for it to change when a person inhales the fungal spores. People with strong immune systems may not have any symptoms at all or may just experience moderate flu-like symptoms such as fever, coughing, exhaustion, chills, and body pains. People who have coccidiomycosis, the condition brought on by Coccidioides, may also develop a rash over their upper body or legs.
It may take a while for the symptoms to manifest. Between three and 17 days after exposure, histoplasmosis, the illness brought on by Histoplasma, may manifest its symptoms in a patient. Coccidiomycosis symptoms, often known as Valley Fever, start to show up one to three weeks after inhaling the spores. The symptoms of blastomycosis, which is brought on by Blastomyces, however, may not appear for three weeks to three months.
In a few weeks to a few months, mild instances often go away on their own. However, some individuals may continue to have symptoms, particularly if the illness worsens.
According to cases reported to the U.S. Centers for Disease Control and Prevention, more than 20,000 people in the United States were diagnosed with coccidiomycosis in 2019, 1,124 people had confirmed or probable cases of histoplasmosis, and there were 240 cases of confirmed or probable blastomycosis. Given that mild instances are likely not recorded and the infections are readily confused with more prevalent lung ailments, the researchers believe that the number is likely understated. However, among the documented cases, more than half of the histoplasmosis and blastomycosis diagnoses resulted in hospitalisation. Patients with histoplasmosis died in around 5% of cases. Likewise, 9% of those who had blastomycosis did.
Some persons may get persistent or severe pneumonia. Additionally, in a tiny percentage of cases, the infections may spread to other body regions. According to Spec, histoplasma “likes to target our intestines, bone marrow, adrenal glands, liver, and spleen.”
Bones and joints are often where Blastomyces spreads. Additionally, it could travel to the brain, where an abscess can develop.
Similar to Blastomyces, Coccidioides spreads by attacking the bones, joints, skin, and brain. The fungus instead induces meningitis, an inflammation of the membranes around the brain and spinal cord, as opposed to causing a brain abscess.
If cancer spreads to your brain, “that’s with you forever,” says Spec. “Cocci cannot be eliminated.” Antifungal medicines may be used to treat brain infections, and other treatments can be prescribed to treat the symptoms.
Most other infections can be cured with antifungal medications. The majority of individuals do really well, he claims, “if discovered early.”
| Danger Signals The three fungus that cause these illnesses, Histoplasma, Coccidioides, and Blastomyces, all have similar symptoms that might be mistaken for the flu or other lung infections. A fungal lung infection may show the following symptoms:
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Who Is The Target Population For These Fungi Infections?
People with compromised immune systems are more susceptible to illness symptoms and serious conditions.
Additionally, males are more likely than women to have serious illnesses and fungus infections. According to the 2019 CDC study, men made up almost 70% of Blastomyces infections, 52% of Coccidioides cases, and 56% of Histoplasma infections.
It’s unclear why men are more impacted than women. Men may have more outside professions and activities that expose them to dirt and, as a result, more fungi, according to some theories.
Uncertainty surrounds Jack Knudsen’s infection. According to Judy, 82, of Oklahoma City, “We have no earthly notion why this came up.” Jack’s immune system wasn’t capable of fighting the fungus since he was already dealing with chronic lymphocytic leukaemia, cardiac issues, and diabetes. She states, “He struggled.
He was hospitalised for two weeks and received antifungal medications intravenously. He continued to take four doses of the liquid antifungal drug itraconazole every day for the remainder of his life. Age 79, he passed away on January 23, 2020. Judy reflects, “We enjoyed 61 excellent years together.
The male-female skew might have biological causes. In nonhuman primates and dogs, the sex difference in coccidiomycosis was also seen, according to recent research. According to Spec, who was not engaged in that research, “there’s very little variation in job exposures and hobbies between male and female” animals.
Up to the age of 19, the researchers discovered no variations in infection rates in people. After then, the male infection rate remained constant. Ian McHardy, a microbiologist and immunologist at Scripps Health in San Diego, and colleagues published this in the March 2022 issue of Open Forum Infectious Diseases. However, the infection incidence among women decreased. This may imply that females often have greater amounts of oestrogen and other hormones, which may act as a defence against fungus. Though it is still only conjecture,
Strangely, those of Filipino or African ancestry may be more likely to have more severe cases of Valley Fever. The cause is not known. All three fungi put individuals at increased risk of developing more serious illnesses, especially those who are pregnant, have HIV/AIDS, or have weaker immune systems due to other conditions. Those who have diabetes and those who are elderly are also.
How Can I Determine If A Fungus Is To Blame For My Infection?
It may be challenging to identify fungal disease since the symptoms of the infections are so similar to those of other ailments, according to Spec.
According to Judy, Jack Knudsen first had seizures in 2018. Initially, physicians believed he had epilepsy, but drugs to treat the condition had little impact. Jack had Histoplasma in his brain, which was discovered by an MRI and another test after one side of his face started to droop. Judy claims, “I had never heard of it in my life. I wanted to share my husband’s experience to raise awareness of the condition.
A fungus infection may be identified via blood or urine testing. It is also possible to employ chest X-rays or CT scans. Doctors may sometimes need to extract a tiny sample of bodily fluid or tissue to test for the fungus.
Many individuals who believe they have a fungal infection are likely not to really have one. Says Spec. It’s an illness that, while still very uncommon, is undoubtedly more frequent than people realise. The new maps that Spec and his colleagues created may increase awareness of the possibility of fungal illnesses among medical professionals and other individuals.
Visit mycoses.org, where Spec and colleagues have put up interactive maps indicating where the fungi are present if you’re worried you could have a fungal infection. “You’ll be able to determine which one you’re at risk for depending on where you reside. Your best course of action is to see a doctor for testing once you have that information.
Any doctor may request a test, although experts in infectious diseases may be better knowledgeable with fungi-related illnesses, according to the doctor.
