Mycotic diseases

March 6, 2003

Immunosuppressed (immunocompromised) individuals are those whose ability to fight infection is severely deficient. This often occurs in those with serious blood disorders or cancers of the blood, chemotherapy patients, transplant recipients, and those with HIV infection or other debilitating diseases.

Mycoses are far more likely to affect immunocompromised individuals. However, some mycoses develop after surgery or invasive procedures and may be transmitted by contaminated instruments. Mycoses are sometimes related to occupational or recreational exposure.

The first symptoms of many of the mycotic diseases are flu-like symptoms of fever, chills, cough, pain in muscles and joints.

Antifungal medications can cause some of the same symptoms as the fungal infection they are given to treat -- chills, fever, and muscle pain. They can also cause kidney damage, and can affect the liver, eyes, or skin. The physician will likely order frequent labwork to intercept serious side-effects from the antifungal agent.

An interesting coincidence

As I formatted this item to put it online, an item in our local news caught my attention. The story was shared about a local woman whose home is being overtaken by birds flocking to the surrounding trees.

A representative from our local Health Department pointed out the health hazard this poses because of the danger of Histoplasmosis from bird droppings.

The reporter also spoke with a bird expert who said that when birds choose a place to call home, it is because they feel this is the safest place on earth to live. He went on to say that it is extremely difficult to convince them that they should move on.

However, with spring approaching, it is felt that the birds will continue their migration to other areas soon. That will be good for the local home-owner, but perhaps not so good for the person who owns the next home they choose to populate!

I'll share some information below about the following serious fungal diseases: Aspergillosis, Blastomycosis, Candidasis, Coccidioidomycosis, Cryptococcosis, and Histoplasmosis.

Aspergillosis

Aspergillosis most often affects lungs, but can spread to other body organs as well, including the brain, skin, and bones. Symptoms are flu-like, common with most mycoses. Usually aspergillosis only affects immunocompromised individuals.

Aspergillus can also cause symptoms like runny nose, wheezing, or asthma flare-ups in those allergic to the mold Aspergillus. This allergy to the mold is not related to the disease aspergillosis.

Blastomycosis

Blastomycosis also resembles the flu. Sometimes it spreads throughout other areas of the body and becomes a chronic disease, and can affect the brain and spinal cord.

At risk individuals include immunocompromised individuals, and occupational or recreational exposure to wooded areas (farmers, forestry workers, hunters, and campers).

Candidiasis

Symptoms of systemic Candidiasis are usually only fever and chills at first. Because it presents such common symptoms, it is easily overlooked. But it should always be suspected in seriously ill patients who do not get better with powerful IV antibiotics.

Eventually, as Candida invades various organs of the body, symptoms maybe specific to the organ invaded, such as pain in the liver or joints, or visual disturbances.

The greatest risk is to hospitalized patients in critical-care units, surgical patients, low birth-weight babies, transplant recipients, and those with a decrease in white blood cells related to chemotherapy (granulocytopenia).

Coccidioidomycosis

Coccidioidomycosis often begins with a flu-like illness. It can become a chronic lung infection or spread throughout the body and infect multiple organs including the brain.

In addition to immunosuppressed individuals, at risk are those with occupational exposure to large amounts of soil dust, women in the third trimester of pregnancy, and African-Americans and Asians.

Cryptococcosis

Cryptococcosis usually begins in the lungs, but without symptoms. It is often not recognized until it spreads to other areas of the body and chills and fever develop. Meningitis (infection of the covering of the spinal chord, and Encephalitis (inflammation of the brain), are common with cryptococcosis.

The greatest risk factor is HIV infection.

Histoplasmosis

Histoplasmosis usually infects the lungs. It can spread to other areas of the body also. Symptoms are similar to other systemic fungal infections, including flu-like symptoms.

In addition to immunocompromised individuals, agricultural workers and others who may be exposed to high amounts of bird or bat droppings are at risk.

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