acute pulmonary histoplasmosis related to occupational roofing: a case report of two brothers

Background and purpose: histoplasma capsulatum is the cause of a prevalent fungal disease in certain regions in the united states of america, like ohio and the mississippi river. its clinical manifestations range from asymptomatic to life-threatening diseases, according to the immune system. a definitive diagnosis is made by biopsy. case report: two middle-aged brothers presented with a nine-day history of severe progressive dyspnea. both were living in cincinnati, ohio, and encountered bird droppings 7 days prior to symptoms while working on a roofing project. it should be mentioned that they were not wearing masks. after extensive testing, they were diagnosed with acute pulmonary histoplasmosis. both were successfully treated with azole-derivative fungal therapy. conclusion: this is the first case of histoplasmosis acquired through occupational exposure related to roofing and is unique given the two patients were siblings.