I actually saw a patient who worked on the farms in the region around the Mississippi river who had Histoplasmosis in the past.
Exposure to bird or bat droppings is a risk factor for Histoplasma capsulatum infection. Found in spelunkers, caves, bats, and bird droppings.
“Histoplasma capsulatum is the fungus that causes histoplasmosis. Commonly found in the Ohio and Mississippi river valleys, Histoplasma capsulatum grows in soil enriched with bat or bird droppings. High-risk activities in endemic areas include spelunking, cleaning of chicken coops, excavation, cutting dead trees, and remodeling or demolition of old houses. Inhalation of Histoplasma capsulatum causes infection with a clinical spectrum ranging from asymptomatic to life-threatening. Patients present with symptoms similar to the flu including fever, sweats, headache, cough, dyspnea, chest pain, anorexia and myalgia. Treatment recommendations are based on the type of histoplasmosis.” RR
It is sometimes called “spelunker’s lung”.
http://umm.edu/health/medical/altmed/condition/histoplasmosis
Fungal Pneumonia facts
- Histoplasmosis: Ohio/Mississippi river valleys, bird/bat droppings
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Blastomycosis: southeastern/south-central/midwestern states, budding yeast, bone lesions
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Coccidioidomycosis: southwest, arthritis, erythema nodosum
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PCP: HIV patient with CD4<200, bat wing pattern on CXR, TMP-SMX + steroids if PaO2 <70