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Thyroid Problems Caused by Histoplasmosis

Histoplasmosis is infection caused by the fungus Histoplasma capsulatum. Breathing spores from the fungus brings on infection, with the most common form of illness being lung infection producing a general ill feeling, fever, chest pain and respiratory symptoms including a dry cough. Rarely, histoplasmosis spreads throughout the body, where it can cause infection of the thyroid among other glands. This form of infection is more likely to occur among people with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), cancer or other diseases that compromise the immune system. When the infection spreads throughout the body, called "disseminated histoplasmosis," it is fatal if not treated.

  1. Thyroid Disease and Histoplasmosis Among HIV/AIDS Patients

    • HIV and AIDS patients commonly develop infections of the thyroid, according to a 1998 study published by Endocrine Pathology. In a 2003 report on an HIV patient at St. Luke's Roosevelt Hospital Center, New York, disseminated histoplasmosis is described as "one of the diseases that characterize acquired immunodeficiency syndrome (AIDS), and in endemic areas ... one of the more commonly observed infections in AIDS patients. ... Histoplasmosis is a well-described opportunistic infection that accompanies human-immunodeficiency virus (HIV) infection."

    Pre-Existing Thyroid Disease

    • The October 2000 Journal of Clinical Microbiology describes fungus infections of the thyroid as rare, with most reported cases involving other species of fungus. A 52-year-old woman with Hashimoto's disease and non-Hodgkin's lymphoma had a large nodule of the thyroid gland caused by histoplasmosis. "The most common predisposing condition for thyroid infection appears to be preexisting thyroid disease," researchers wrote.

    Treatment

    • Histoplasmosis can be treated with antifungal medications. The woman in the Journal of Clinical Microbiology report responded well to treatment with itraconazole. "Oral itraconazole is effective for mild or moderately severe clinical forms of histoplasmosis," researchers wrote. "The introduction of azole agents such as itraconazole has moved the treatment of histoplasmosis from an inpatient to an outpatient setting. However, in severe histoplasmosis, amphotericin B is the preferred agent."

    How People Get Histoplasmosis

    • Histoplasma capsulatum, the fungus that causes histoplasmosis, grows in soil and in materials contaminated with bird or bat droppings. When the soil or droppings are disturbed, spores become airborne and can be breathed into the lungs. The fungus is found worldwide and is common in the eastern and central regions of the United States.

    How to Avoid Histoplasmosis

    • The best way to avoid histoplasmosis is to avoid areas where the fungus is likely to exist--among accumulations of bird or bat droppings. If you must be in such an area to do work such as farming, bridge inspecting or painting, restoring historic buildings or demolition, you can help protect yourself by wearing protective equipment, controlling dust and properly disposing of waste materials. A full discussion of steps to take to reduce exposure to histoplasmosis can be found online on the National Institute of Occupational Safety and Health website.

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