The result of a biopsy that came to the clarification in Rambam, amazed the doctors and researchers. The test found an infection that had never been diagnosed before in the entire Mediterranean region
The disease histoplasmosis, also known as the "cavemen's disease", is widespread in the southern United States and Latin America. An American doctor who works in Mississippi, for example, or doctors who treat travelers returning from Central and South America will be very familiar with the disease that even caused the singer Bob Dylan to cancel a tour after contracting it On the other hand, histoplasmosis was never diagnosed in a person infected with it in Israel, until recently the disease was found under the circumstances Abnormalities in a woman from the Galilee. The unique case was accepted for publication in the scientific magazine American Journal of Tropical Medicine and Hygiene.
"Cave explorers' disease" got its exotic name because the fungus that causes it (histoplasma fungus) is found in the excrement of bats and other birds, and cave explorers (especially those that are dark, humid and require crawling) inhale it into the respiratory system and are at high risk of contracting it. In 1977, a speleologist identified the fungus in a bat in Yodafat Cave in the Galilee. This report was indeed published, but in the absence of diagnosed cases in humans in Israel, in Israel the disease was considered to be the property of the Israeli mucilages from Latin America.
Recently, this figure changed, when Rambam researchers and doctors encountered the first case of its kind: "A few months ago, we received a biopsy taken from the pharynx of a woman in the 50s as part of a diagnosis she underwent at another hospital," recalls Dr. Ami Neuberger, director of the tropical diseases clinic and traveler's medicine at Rambam, and a senior physician in the infectious diseases unit at the hospital, "Such lesions, in the 'Israeli' way of thinking, are often Malignant, but here the case was different."
Due to the unclear diagnosis, the biopsy was sent to Rambam and the results of the tests in the pathology laboratory were surprising. Instead of cancer cells, the histoplasma fungi were observed in the test. "I did not believe the result at first," says Dr. Neuberger, "but specific tests in the microbiology laboratory confirmed the diagnosis. The question The first thing I asked the patient, who lives in the Galilee region, was 'where did you travel?' It turned out that the woman had never left the country's borders."
Usually it is a disease that affects the lungs only, it is relatively mild, and is not transmitted from person to person. In this case, the woman suffered for months from general weakness, significant weight loss, and a lump in her throat that caused hoarseness and difficulty speaking. Until she was diagnosed, she was in very poor physical condition. "Treating an infectious disease is sometimes like magic," explains Dr. Neuberger, "After we started the treatment with an antifungal drug, the symptoms disappeared within a few weeks."
So how did the disease make it all the way from South America to the Galilee? Dr. Neuberger provides an explanation: "With all the difficulty in diagnosing the disease, when a traveler returns from South America with appropriate symptoms, it is easier to understand what it is about. But this case is unusual because the disease was not known here before. The interesting question is how and where the woman contracted the disease," he continues and says, "When you look at the map, you see that the Yodaf cave where the fungus was found in the bat in 1977 is very close to the area where the woman lives. We tried to find the fungus in Yodafat Cave and in the area where the patient lives. No fungus was found in any of the samples, although as compensation we were treated like a king, and most tourists did not stay in the Bat Cave... It is possible that construction work in the area, during which a number of caves were blown up for the purpose of digging foundations, caused the spread of a "fungal cloud" that led to the infection. This is of course not a fact but only a hypothesis. I hope this is the first and last case in Israel. Days will tell..."
Watch: From the days of cholera in London of previous centuries to the effects of the global village on epidemics today. Dr. Ami Neuberger in a review on the subject toRambam Doc Talk
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