Rambam Doctors Surprised by Histoplasmosis

Histoplasmosis, better known as “cave disease,” usually found in the central and southern U.S., has turned up in Israel, The Jerusalem Post reported on Monday.

Doctors at Rambam Medical Center in Haifa recently finished treating a woman with histoplasmosis, the first case ever diagnosed in the Middle East.

The disease, caused by a fungus found in soil – typically from bird droppings or bat guano – usually passes without treatment. But sometimes the infection damages the lungs and requires anti-fungal medications. If left untreated it can be fatal. It is not contagious.

“A few months ago, we received a biopsy taken from a woman’s pharynx in the course of a diagnosis in another hospital,” recalled Dr. Ami Neuberger, director of the tropical diseases clinic.

“Such lesions are thought here to usually be malignant, but this case was different; I did not believe the result at the beginning,” Neuberger said. “Specific tests in the microbiological laboratory confirmed the diagnosis. I immediately asked the patient, who lives in the Galil, ‘Where did you go?’ To my surprise, it turned out that the woman never left the country.”

She had been suffering for months from general weakness, weight loss and a lump in the throat that caused hoarseness and impaired her speech. Treatment with an anti-fungal drug eliminated the symptoms within a few weeks.

Staff at Rambam were puzzled as to how she contracted the disease, but eventually suspicion fell on the Yodfat cave in the Galil.

“It is very close to the area where the woman lives. We tried to find the fungus in the Yodfat cave and in the patient’s neighborhood, but no fungus was found in any of the samples,” said Neuberger. “Perhaps a number of caves were dug to excavate the foundations. This, of course, is not a fact but a hypothesis. I hope this is the first and last case in Israel.”