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Deadly Fungus Attacks Lungs

April 26, 2010
Written by: , Filed in: Chest Radiology
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Unusual lung lesions seen on chest X-rays and CT scans a decade ago in British Columbia provided the first warning about a deadly fungus that’s spreading through the Pacific Northwest. Researchers have now found that it’s getting stronger as it spreads.

Cryptococcus gattii, an airborne fungus normally seen only in tropical and subtropical regions, mysteriously showed up in 1999 on Canada’s Vancouver Island. Nobody knows how it got there or why it’s thriving in a temperate climate. So far, it has killed 19 of 218 known victims (8.7 percent) in the province of British Columbia. Since 2004, it has been reported in Washington and Oregon as well.

A study published on April 22 in the journal PLoS Pathogens reported that a new, highly virulent strain has appeared in Oregon, where it has killed 6 of 21 known victims—a frightening mortality rate of more than 28 percent. Even scarier is the fact that, though fungal infections typically strike people with weakened immune systems, most Cryptococcus gattii victims have been otherwise healthy.

The study warns that the disease is likely to spread into Northern California and possibly beyond. Edmond Byrnes, one of the study’s co-authors, told National Geographic:

The alarming thing is that it’s occurring in this region, it’s affecting healthy people, and geographically it’s been expanding.

The infection begins when the fungal spores, found on and near trees, are inhaled. The fungus starts to grow in the lungs, creating pulmonary nodules or opacities. An estimated 20 percent of victims develop meningitis. The disease has also been found in a variety of domestic and wild animals, even dolphins.

There is some good news. The disease seems to infect only a tiny percentage of those who are exposed to it. It cannot spread from person to person, and it can be treated with antibiotics, although treatment often must continue for months.

As with most diseases, early diagnosis greatly improves the prognosis. However, Cryptococcus gattii can lurk undetected in the body for a long time. From the point of infection it takes an average of six months for symptoms to appear. The symptoms vary, but often include coughing and shortness of breath, night sweats, fever and chills, headache, chest pain, neck pain and stiffness, weight loss, light sensitivity and decreased alertness.

The PLoS Pathogens article points out that even those outside the Pacific Northwest should be on the alert for this infection:

The potential dangers of travel-associated risks should be noted, as a growing number of cases attributable to travel within the Pacific NW region have been documented.

Related seminar: Thoracic Imaging


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