DEAR DR. DONOHUE: I have been diagnosed with histoplasmosis of the lungs. I picked it up from taking care of chickens when I was growing up. I have been in excellent health. A few years ago I had pneumonia. X-rays showed that I also had histoplasmosis. The doctor never mentioned anything about treatment for it. This year I have a tight chest and a dry cough. I saw the doctor, and he said my X-ray had not changed. Are my symptoms due to histoplasmosis? Is there any treatment for it? Is it cancer? – M.

ANSWER: Histoplasmosis is a common – but not commonly discussed – fungal infection that is seen all over the world. In the United States, it is prevalent in the Southeast, mid-Atlantic and Central regions. It is very common in the Ohio and Mississippi valleys.

The fungus grows in moist soil that has been enriched by bird droppings, and it also grows in caves where there are bat droppings. Cleaning the floors of chicken coops is one way of catching the fungus. Construction workers, when they stir up the soil, can also breathe in the fungus and have it settle in their lungs.

In some places, 80 percent of the people have been infected, but few of them ever develop any symptoms. Initial symptoms, when they do occur, are often dismissed as a minor respiratory infection and are promptly forgotten. Later in life, when a chest X-ray is taken for an unrelated matter, the typical pattern of lung calcifications caused by histoplasmosis is seen. The doctor then tells the patient that he or she had a previous encounter with this fungus. Such old infections, like yours, seldom need any treatment. The fungus is buried in calcium coffins and does not hurt the lungs.

Treatment is necessary when the initial infection causes dramatic symptoms or when it spreads throughout the body. Such cases are rare. There are antifungal medicines available when such is the case. Your old histoplasmosis infection is not likely the cause of your current symptoms. Histoplasmosis is not and does not become cancer.

DEAR DR. DONOHUE: I have type-2 diabetes and keep it controlled with diet. I was told that chromium picolinate stabilizes blood sugar. I would appreciate any information on this. – A.L.

ANSWER: Chromium enhances the action of insulin in getting sugar out of the blood and into body cells. That statement holds out the promise of chromium being a valuable adjunct in the treatment of diabetes. However, current data are insufficient to warrant a glowing endorsement of chromium for diabetes. You can try it and see if it works for you. Don’t go overboard in its use. Stick to the label’s recommendations regarding amounts, and let your doctor know what you’re doing.

The diabetes booklet discusses all aspects of this disease and its treatment. Readers can order a copy by writing: Dr. Donohue – No. 402, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I lost my mother to what the doctor called unsurvivable gram-negative infection. What is it, and what causes it? Is it contagious? Is it treatable? – P.H.

ANSWER: The bacterial world is divided into two kingdoms based on how bacteria react to a dye in preparation for microscopic examination. One kingdom of bacteria turns a blue color with the stain and is called gram-positive. (“Gram” is the name of the doctor who devised the stain.) Bacteria of the other kingdom turn red when stained. They’re gram-negative.

The distinction is important for choosing the proper antibiotic and for making a prognosis regarding outcome.

Gram-negative blood infections – most likely what your mother had – can be lethal. Gram-negative bacteria release products that lower blood pressure, affect the heart’s pumping and can impair kidney and liver function. There are antibiotics for these infections, but they often fail to turn the tide of infection in favor of the patient. Gram infections don’t usually spread from one person to another. Mostly they arise from the large population of gram-negative bacteria that live in our colons.



Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.