Potentially deadly fungus leaves dozens sickened as infection spreads across southern state
Health officials in Tennessee are warning the public about a potentially deadly fungal infection that has been spreading in parts of the state.
More than 35 cases of histoplasmosis—a lung infection caused by the fungus Histoplasma capsulatum—have been confirmed over a three-month period in Maury and Williamson counties, according to data presented by the Tennessee Department of Health on Jan. 12.
A local family has reported that a woman died after contracting the illness, noting that a positive test result was returned two days after her death. State epidemiologists, however, said during a briefing to the Williamson County Board of Commissioners that an investigation is ongoing and that histoplasmosis has not yet been confirmed as the direct cause of any deaths.
Officials also reported that the average age of those infected is 50.
The fungus that causes histoplasmosis is found in soil contaminated with bird or bat droppings. People become infected by breathing in fungal spores, often when soil is disturbed. Health officials say they have not identified a single common source linked to the recent Tennessee cases.
Most people exposed to the fungus do not become ill, but histoplasmosis can cause respiratory symptoms that range from mild to life-threatening, according to the Centers for Disease Control and Prevention. Symptoms typically appear three to 17 days after exposure and may include fever, cough, extreme fatigue, headaches, body aches, chills, and chest pain.
Because these symptoms resemble those of the flu or a common cold, the illness is frequently overlooked or misdiagnosed.
Dr. Zaid Fadul, CEO of Bespoke Concierge MD in California, said the general public is not considered at high risk. “Most of the time, we don’t get sick because the amount of spores we breathe in is minimal,” he said. However, people with weakened immune systems or those exposed to large amounts of spores face a greater risk. “If the immune system is compromised, histoplasmosis can run amok and cause a life-threatening illness,” Fadul warned.
While many cases resolve without treatment, antifungal medications are available for more severe infections. State officials confirmed that some Tennessee patients have been hospitalized, and several are considered critically ill.
Doctors can diagnose histoplasmosis through laboratory testing of blood or urine samples. Additional diagnostic tools may include respiratory fluid tests, imaging scans such as X-rays or CT scans, or tissue biopsies.
To reduce the risk of infection, health officials recommend avoiding activities that disturb soil and wearing masks during high-risk outdoor activities. “Being outside is healthy, but if conditions are dusty or exposure is prolonged, wearing a mask can help limit the spores you breathe in,” Fadul said.
Before this outbreak, histoplasmosis was classified as a reportable disease in only 14 states, according to the CDC. The infection does not spread from person to person or from humans to animals.
Anyone experiencing persistent respiratory symptoms who believes they may have been exposed to the fungus is urged to contact a healthcare provider, especially if antibiotics are not effective. “With increased awareness and improved testing, vague respiratory illnesses can now lead to faster diagnosis and treatment,” Fadul said. “Histoplasmosis can be deadly to certain patients, but it doesn’t have to be.”
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