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