Batting in Nicaragua Postscript: Histoplasmosis

Eleven days after returning from Nicaragua (see Batting in Nicaragua without Jose) my wife Aram went to bed with flu-like symptoms and has now been down for 19 days.  A friend sent us this article about a group of students contracting histoplasmosis in a Nicaraguan bat cave, (Histoplasmosis from Nicaragua cave) and the symptoms matched Aram’s closely, including an unusual chest X-ray and CT scan (also see Histoplasmosis ).   The only major difference was an 11-day incubation period for the students vs 17 days from cave visit to being overtly sick for Aram.  Three nights ago we ended up in the emergency room (driving  50 minutes through a blizzard because Aram was experiencing tunnel-vision and blindness is a rare outcome).    Thankfully, that symptom disappeared overnight and overall she is improving steadily now. Indeed the doctors have recommended waiting a couple weeks and only then, if she is not better, doing an anti-fungal treatment because the cure is almost as nasty as the disease.

We did take precautions, wearing respirators, rubber gloves, and safety glasses (see Richard Webb’s Costa Rica report), but Aram’s respirator did not fit well, and we had to remove our foggy safety glasses to see the bats.  We were in the caves less than 10 minutes but spent much longer at the entrance to examine netted bats.   Ron has been sick with respiratory symptoms for about two weeks, but yesterday an X-ray showed no signs of histoplasmosis.    I never became sick, perhaps because I am 10 & 15” taller than Ron and Aram, respectively and thus a bit removed from the ankle-deep guano. Rolando did not enter the cave and Maynor has not been sick; indeed he has revisited the caves recently.

We keep things lively for our rural Maine doctors, bringing them back interesting biota like Plasmodium falciparum (the form of malaria that kills you if untreated), botflies, and Rickettsia africae (cause of African tick bite fever).    But we would rather be medically boring.

9 Comments
  1. Vladimir Dinets 8 months ago

    How come I never get anything interesting? At least half of my friends have had botflies, and I’m yet to even see one.

  2. Profile photo of machunter Author
    machunter 8 months ago

    Many years ago we returned from Peru with a friend and her botfly. Initially she treated it almost as a pet, intending to nourish it through to emergence, but it proved too painful so she removed it to a vial of alcohol.

  3. Curtis Hart 8 months ago

    I had a cough when I entered the caves on Jan 20th, which has just gone away. I was the only one of our group that entered the caves, so hopefully we are in the clear. Thank you for the warning about this. Sorry you found out the hard way.

    Curtis

  4. Profile photo of machunter Author
    machunter 8 months ago

    Glad you fared better than Aram and Ron; will look forward to hearing a report on the rest of your trip…mac

  5. Profile photo of Jon Hall
    Jon Hall 8 months ago

    Sounds very nasty Mac. Did the Dr confirm histoplasmosis? Sounds like there is a good deal of evidence for Aram but not for Ron .. in which case do they have the same lurgy, or coincidentally sick with different things? What do you think. In any case hope she recovers fully very soon.

  6. Profile photo of machunter Author
    machunter 8 months ago

    I think we are 90% sure with Aram; we are waiting for the results of various lab tests but false negatives are very common. For Ron, it is a worrying mystery as he is not getting better and to date his doctor has done little testing beyond looking at an X-ray. Aram is definitely on the mend and I am optimistic she will be fine in time for an early March trip to Costa Rica looking for a silky anteater.

  7. Vladimir Dinets 8 months ago

    There are fairly accurate tests (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2863343/); in any case X-ray is absolutely not enough and if there’s no improvement, delaying treatment might be a very serious mistake. Get another doctor.

  8. Profile photo of machunter Author
    machunter 8 months ago

    Thanks Vladmir. I will share this with Ron. Fortunately both he and Aram (who did have a CT scan and various lab tests for which we are awaiting results) report feeling much better today. That said, I agree that he needs a more aggressive doctor….mac

  9. Vladimir Dinets 8 months ago

    Glad to hear that. Keep us posted. I might be able to find a specialist at CDC if needed.

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