What are the symptoms of histoplasmosis (Histoplasma capsulatum infection)?

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From the Guidelines

Histoplasmosis symptoms typically include fever, chills, headache, muscle aches, dry cough, and chest discomfort, and can develop within 3-17 days after exposure to the fungus Histoplasma capsulatum, as reported in the 2007 update by the Infectious Diseases Society of America 1. The severity of symptoms can vary widely depending on the individual's immune status and the level of exposure to the fungus.

  • In mild cases, symptoms often resolve without treatment within a few weeks.
  • More severe infections may cause weight loss, shortness of breath, fatigue, and night sweats.
  • Disseminated histoplasmosis, which occurs when the infection spreads beyond the lungs, can cause additional symptoms including mouth sores, liver and spleen enlargement, and skin lesions.
  • Immunocompromised individuals are at higher risk for severe disease, including progressive disseminated histoplasmosis, which can be life-threatening if untreated, as noted in the clinical practice guidelines for the management of patients with histoplasmosis 1. The fungus primarily enters the body through inhalation of spores found in soil contaminated with bird or bat droppings, particularly in the Ohio and Mississippi River valleys of the United States.
  • Diagnosis typically requires laboratory testing since symptoms alone are often indistinguishable from other respiratory infections, as stated in the guidelines for the management of patients with histoplasmosis 1. It is essential to consider the patient's immune status and the severity of symptoms when determining the best course of treatment, as recommended in the 2007 update by the Infectious Diseases Society of America 1.

From the Research

Symptoms of Histoplasmosis

The symptoms of histoplasmosis (Histoplasma capsulatum infection) can vary depending on the severity of the infection and the individual's immune status. Some common symptoms include:

  • Fever 2, 3, 4
  • Fatigue 2
  • Cough 2, 4
  • Weight loss 2
  • Abdominal pain 4
  • Joint pain 4
  • Skin changes 4
  • Superficial lymph node enlargement 4
  • Hepatosplenomegaly 4
  • Pancytopenia (a condition characterized by a reduction in the number of red and white blood cells, as well as platelets) 4
  • Abnormal liver function 4
  • Abnormal coagulation function 4

Severity of Symptoms

The severity of symptoms can range from mild to severe. Pulmonary histoplasmosis tends to have milder symptoms, such as dry cough 4, while progressive disseminated histoplasmosis can have more severe symptoms, including recurrence of high fever, superficial lymph node enlargement, hepatosplenomegaly, and abdominal pain 4.

Adrenal Involvement

In some cases, histoplasmosis can affect the adrenal glands, leading to adrenal insufficiency 3. This can present with symptoms such as fatigue, weight loss, and abdominal pain.

Disseminated Histoplasmosis

Disseminated histoplasmosis can affect multiple systems in the body, including the lungs, liver, spleen, and lymph nodes 2, 4. Symptoms can include fever, fatigue, weight loss, and abdominal pain, as well as more severe symptoms such as hepatosplenomegaly and pancytopenia 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

[Clinical comparative analysis for pulmonary histoplasmosis and progressive disseminated histoplasmosis].

Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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