Histoplasmosis

Our soil within the Ohio River Valley is considered some of the most fertile.  This soil is also known to grow a fungus that infects up to 80% of the Ohio River Valley inhabitants. With part of Appalachian lying within the Ohio River Valley, our population is often affected by this fungus, known as Histoplasmosis.  In fact, it is an endemic mycosis that I used as my undergraduate thesis while studying at Tennessee Technological University School of Nursing in Cookeville, TN.  Some projections indicate that up to 80% of the population living in this area would test positive on a histoplasmosis skin test which is similar to a TB skin test.  However, the majority of infections go unrecognized.  Symptoms are self-limiting and mimic a common cold.  Often, one never knows they are infected.  Although in some cases when one is exposed to a large amount of fungus spores (such as when I was infected), it can lead to fungal pneumonia and later develop ocular histoplasmosis.  The presentation of ocular histoplasmosis is the same as macular degeneration and often leads to blindness in one or both eyes.  Thankfully, the majority of infections go unnoticed and may display as a single nodule on chest Xray.  To become infected with histoplasmosis, one must come into contact with soil containing the fungal spores.  Specifically, soil where bird, chicken or bat droppings have been present.  In my case, I feel using chicken manure for fertilizer and tearing down old chicken houses may have led to the larger spore count.  It is my recommendation, when in dusty environments, one should wear a mask while plowing or cultivating fields.  However, it is interesting to note one outbreak occurred during Earth Day when a large number of children were infected while simply planting a few pine trees.