Once thought to be a rare, always fatal disease, histoplasmosis is now recognized as one of the most prevalent fungal infections in North America. It infects hundreds of thousands of people every year, and its distribution is growing. In this episode, we dissect this abundant fungus, examining how it makes us sick, who tends to get sick, and what we can do about it. We also take you through the history of this fungus, a story that features a surprise discovery, more evidence that everything is tuberculosis, and a spotlight on an extinct bird. Curious to know how all the pieces fit together? Tune in for the full picture.
| History | Biology |
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| Benedict, Kaitlin, and Rajal K. Mody. “Epidemiology of histoplasmosis outbreaks, United States, 1938–2013.” Emerging infectious diseases 22.3 (2016): 370. | Valdez, A.F., Miranda, D.Z., Guimarães, A.J., Nimrichter, L. and Nosanchuk, J.D., 2022. Pathogenicity & virulence of Histoplasma capsulatum-A multifaceted organism adapted to intracellular environments. Virulence, 13(1), p.2137987. |
| Chick, Ernest W., et al. “Hitchcock’s birds, or the increased rate of exposure to Histoplasma from blackbird roost sites.” Chest 80.4 (1981): 434-438. | Kurowski, R. and Ostapchuk, M., 2002. Overview of histoplasmosis. American Family Physician, 66(12), pp.2247-2253. |
| Darling, Samuel T. “A PROTOZOÖN GENERAL INFECTION PRODUCING PSEUDOTUBERCLES IN THE LUNGS AND FOCAL NECROSES IN THE LIVER, SPLEEN AND LYMPHNODES.” Journal of the American Medical Association 46.17 (1906): 1283-1285. | Hage, C.A., Azar, M.M., Bahr, N., Loyd, J. and Wheat, L.J., 2015, October. Histoplasmosis: up-to-date evidence-based approach to diagnosis and management. In Seminars in respiratory and critical care medicine (Vol. 36, No. 05, pp. 729-745). Thieme Medical Publishers. |
| Deepe Jr, George S. “Outbreaks of histoplasmosis: the spores set sail.” PLoS pathogens 14.9 (2018): e1007213. | Scolarici, M.J. and Smith, J., 2025. Histoplasmosis and blastomycosis: Progress and possibilities. CMI Communications, 2(2), p.105067. |
| Bennett, John E., Raphael Dolin, and Martin J. Blaser. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases E-Book: 2-volume set. Elsevier health sciences, 2019. | Dao, A., Kim, H.Y., Halliday, C.L., Oladele, R., Rickerts, V., Govender MMed, N.P., Shin, J.H., Heim, J., Ford, N.P., Nahrgang, S.A. and Gigante, V., 2024. Histoplasmosis: A systematic review to inform the World Health Organization of a fungal priority pathogens list. Medical Mycology, 62(6), p.myae039. |
| Diaz, James H. “Environmental and wilderness-related risk factors for histoplasmosis: more than bats in caves.” Wilderness & environmental medicine 29.4 (2018): 531-540. | Mazi, P.B., Sahrmann, J.M., Olsen, M.A., Coler-Reilly, A., Rauseo, A.M., Pullen, M., Zuniga-Moya, J.C., Powderly, W.G. and Spec, A., 2023. The geographic distribution of dimorphic mycoses in the United States for the modern era. Clinical Infectious Diseases, 76(7), pp.1295-1301. |
| Fass, Robert J., and Samuel Saslaw. “Earth Day histoplasmosis: a new type of urban pollution.” Archives of Internal Medicine 128.4 (1971): 588-590. | Taylor, M.L., Reyes-Montes, M.D.R., Estrada-Bárcenas, D.A., Zancopé-Oliveira, R.M., Rodríguez-Arellanes, G. and Ramírez, J.A., 2022. Considerations about the geographic distribution of Histoplasma species. Applied and Environmental Microbiology, 88(7), pp.e02010-21. |
| Furcolow, M. L., et al. “Serologic evidence of histoplasmosis in sanatoriums in the US.” JAMA 180.2 (1962): 109-114. | Falci, D.R., Dalla Lana, D.F. and Pasqualotto, A.C., 2021. The era of histoplasmosis in Brazilian endemic mycoses. The Lancet Regional Health–Americas, 3. |
| George, Mary E., et al. “The impact of climate change on the epidemiology of fungal infections: implications for diagnosis, treatment, and public health strategies.” Therapeutic Advances in Infectious Disease 12 (2025): 20499361251313841. | Bahr, N.C., Antinori, S., Wheat, L.J. and Sarosi, G.A., 2015. Histoplasmosis infections worldwide: thinking outside of the Ohio River valley. Current tropical medicine reports, 2(2), pp.70-80. |
| Grayston, J. Thomas, and Michael L. Furcolow. “The occurrence of histoplasmosis in epidemics—epidemiological studies.” American Journal of Public Health and the Nations Health 43.6_Pt_1 (1953): 665-676. | Diaz, J.H., 2018. Environmental and wilderness-related risk factors for histoplasmosis: more than bats in caves. Wilderness & environmental medicine, 29(4), pp.531-540. |
| Gugnani, Harish C., and David W. Denning. “Infection of bats with Histoplasma species.” Medical mycology 61.8 (2023): myad080. | Adenis, A.A., Valdes, A., Cropet, C., McCotter, O.Z., Derado, G., Couppie, P., Chiller, T. and Nacher, M., 2018. Burden of HIV-associated histoplasmosis compared with tuberculosis in Latin America: a modelling study. The Lancet Infectious Diseases, 18(10), pp.1150-1159. |
| Gustafson, Tracy L., et al. “Outbreak of acute pulmonary histoplasmosis in members of a wagon train.” The American Journal of Medicine 71.5 (1981): 759-765. | Eissenberg, L.G. and Goldman, W.E., 1991. Histoplasma variation and adaptive strategies for parasitism: new perspectives on histoplasmosis. Clinical microbiology reviews, 4(4), pp.411-421. |
| White, F. Clark, and Harry E. Hill. “Disseminated Pulmonary Calcification, A Report of 114 Cases with Observations of an Antecedent Pulmonary Disease in 15 Individuals.” American Review of Tuberculosis 62.1 (1950): 1-16. | Benedict, K. and Mody, R.K., 2016. Epidemiology of histoplasmosis outbreaks, United States, 1938–2013. Emerging infectious diseases, 22(3), p.370. |
| Jackson, Jerome A. “A Message from Martha.” The Wilson Journal of Ornithology 127.3 (2015): 556-560. | |
| Ireland, Merritte W. “Physical defects discovered in selective draft men during the world war.” Journal of the American Medical Association 79.19 (1922): 1579-1581. | |
| Kasuga, Takao, et al. “Phylogeography of the fungal pathogen Histoplasma capsulatum.” Molecular ecology 12.12 (2003): 3383-3401. | |
| Leznoff, Arthur, et al. “Histoplasmosis in Montreal during the fall of 1963, with observations on erythema multiforme.” Canadian Medical Association Journal 91.22 (1964): 1154. | |
| Limper, Andrew H., et al. “Fungal infections in HIV/AIDS.” The Lancet Infectious Diseases 17.11 (2017): e334-e343. | |
| Long, Esmond R., and William H. Stearns. “Physical examination at induction: standards with respect to tuberculosis and their application as illustrated by a review of 53,400 X-ray films of men in the Army of the United States.” Radiology 41.2 (1943): 144-150. | |
| Maiga, Amelia W., et al. “Mapping histoplasma capsulatum exposure, United States.” Emerging infectious diseases 24.10 (2018): 1835. | |
| Manos, Nicholas E. “The tornado as an epidemiological research tool.” Bulletin of the American Meteorological Society 39.9 (1958): 460-468. | |
| McGee, W. J. “Notes on the passenger pigeon.” Science 32.835 (1910): 958-964. | |
| Murray, Gemma GR, et al. “Natural selection shaped the rise and fall of passenger pigeon genomic diversity.” Science 358.6365 (2017): 951-954. | |
| North, John. “BACK TO THE SOIL.” Medical Record (1866-1922) 86.23 (1914): 969. | |
| Novak, Ben J., et al. “Experimental investigation of the dietary ecology of the extinct passenger pigeon, Ectopistes migratorius.” Frontiers in Ecology and Evolution 6 (2018): 20. | |
| PALMER, GEORGE THOMAS. “GENERAL HEALTH ACTIVITIES AND THEIR EFFECT ON TUBERCULOSIS MORTALITY.” Journal of the American Medical Association 73.13 (1919): 985-987. | |
| Baker, Roger D. “Proceedings International Symposium on Mycoses.” (1971): 548-548. | |
| ROBISON, JOHN A. “TUBERCULOSIS IN THE MIDDLE STATES AND ITS CURABILITY.” Journal of the American Medical Association 37.26 (1901): 1718-1721. | |
| Schwarz, Jan, and Gerald L. Baum. “The history of histoplasmosis, 1906 to 1956.” New England Journal of Medicine 256.6 (1957): 253-258. | |
| Seidel, Danila, et al. “Impact of climate change and natural disasters on fungal infections.” The Lancet Microbe 5.6 (2024): e594-e605. | |
| Taylor, Maria Lucia, et al. “Considerations about the geographic distribution of Histoplasma species.” Applied and Environmental Microbiology 88.7 (2022): e02010-21. | |
| Wheat, L. Joseph. “Histoplasmosis in Indianapolis.” Clinical infectious diseases 14.Supplement_1 (1992): S91-S99. | |
| WHEAT, LAWRENCE JOSEPH, et al. “A large urban outbreak of histoplasmosis: clinical features.” Annals of Internal Medicine 94.3 (1981): 331-337. | |
| White, F. Clark, and Harry E. Hill. “Disseminated Pulmonary Calcification, A Report of 114 Cases with Observations of an Antecedent Pulmonary Disease in 15 Individuals.” American Review of Tuberculosis 62.1 (1950): 1-16. | |
| Dauer, C. C., and L. L. Lumsden. “The Distribution of Tuberculosis Mortality in Southeastern United States.” American Review of Tuberculosis 35.1 (1937): 43-61. |
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One thought on “Episode 210 Histoplasmosis: Bats, birds, and budding yeast”
Erin’s! I have also been fascinated and saddened by the story of the passenger pigeon since I first heard the story. I found your association with this disease equally fascinating. I remember one detail that you didn’t mention and wondered if you would find it interesting as well. The account I heard (of course I cannot remember the source) recounted people walking in to flocks of passenger pigeons and throwing them in to sacks to catch them as they rested right on or near the ground. The flocks were so large the birds relied on sheer numbers and had virtually no fear of predators. Any natural predator would simply get full & tired and never affect their numbers …. Until the colonization of America by Europeans, sigh!
Humans also contaminated themselves walking right through the flocks.
Thanks so much I always enjoy your show and have been a listener from the beginning.