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Histoplasmosis in a state where it is not known to be endemic--Montana, 2012-2013.
MMWR Morb Mortal Wkly Rep. 2013 Oct 25; 62(42):834-7.MM

Abstract

Histoplasmosis is caused by infection with the dimorphic fungus, Histoplasma capsulatum, following inhalation of contaminated soil. Among symptomatic patients, the most common clinical presentation is acute pneumonia. Persons with compromised immune systems are at risk for disseminated histoplasmosis, a severe illness requiring antifungal therapy that is often characterized by fever, malaise, anorexia, and weight loss. H. capsulatum is endemic in the Ohio River and Mississippi River valleys, where it is found in soil enriched with bird droppings and bat guano. During November 2012-February 2013, histoplasmosis was diagnosed in four Montana residents by four different physicians. No epidemiologic links among the cases were identified. Each patient's medical records were reviewed, and their exposure and travel histories were obtained. Three patients reported no recent travel outside of Montana and likely were exposed in Montana, which is west of areas where H. capsulatum is recognized as endemic. One patient reported recent travel to California, where she was exposed to potting soil containing bat guano. Low clinical suspicion, probably related to lack of history of exposure to areas where H. capsulatum is known to be endemic, likely delayed diagnosis and appropriate therapy for three patients. Health-care providers should be aware of the possibility of histoplasmosis in Montana and consider the diagnosis in patients with clinically compatible illnesses.

Authors

No affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24153314

Citation

Centers for Disease Control and Prevention. "Histoplasmosis in a State Where It Is Not Known to Be endemic--Montana, 2012-2013." MMWR. Morbidity and Mortality Weekly Report, vol. 62, no. 42, 2013, pp. 834-7.
Centers for Disease Control and Prevention. Histoplasmosis in a state where it is not known to be endemic--Montana, 2012-2013. MMWR Morb Mortal Wkly Rep. 2013;62(42):834-7.
Centers for Disease Control and Prevention. (2013). Histoplasmosis in a state where it is not known to be endemic--Montana, 2012-2013. MMWR. Morbidity and Mortality Weekly Report, 62(42), 834-7.
Centers for Disease Control and Prevention. Histoplasmosis in a State Where It Is Not Known to Be endemic--Montana, 2012-2013. MMWR Morb Mortal Wkly Rep. 2013 Oct 25;62(42):834-7. PubMed PMID: 24153314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Histoplasmosis in a state where it is not known to be endemic--Montana, 2012-2013. A1 - ,, PY - 2013/10/25/entrez PY - 2013/10/25/pubmed PY - 2013/12/18/medline SP - 834 EP - 7 JF - MMWR. Morbidity and mortality weekly report JO - MMWR Morb Mortal Wkly Rep VL - 62 IS - 42 N2 - Histoplasmosis is caused by infection with the dimorphic fungus, Histoplasma capsulatum, following inhalation of contaminated soil. Among symptomatic patients, the most common clinical presentation is acute pneumonia. Persons with compromised immune systems are at risk for disseminated histoplasmosis, a severe illness requiring antifungal therapy that is often characterized by fever, malaise, anorexia, and weight loss. H. capsulatum is endemic in the Ohio River and Mississippi River valleys, where it is found in soil enriched with bird droppings and bat guano. During November 2012-February 2013, histoplasmosis was diagnosed in four Montana residents by four different physicians. No epidemiologic links among the cases were identified. Each patient's medical records were reviewed, and their exposure and travel histories were obtained. Three patients reported no recent travel outside of Montana and likely were exposed in Montana, which is west of areas where H. capsulatum is recognized as endemic. One patient reported recent travel to California, where she was exposed to potting soil containing bat guano. Low clinical suspicion, probably related to lack of history of exposure to areas where H. capsulatum is known to be endemic, likely delayed diagnosis and appropriate therapy for three patients. Health-care providers should be aware of the possibility of histoplasmosis in Montana and consider the diagnosis in patients with clinically compatible illnesses. SN - 1545-861X UR - https://www.unboundmedicine.com/medline/citation/24153314/Histoplasmosis_in_a_state_where_it_is_not_known_to_be_endemic__Montana_2012_2013_ L2 - https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6242a2.htm DB - PRIME DP - Unbound Medicine ER -