Histoplasmosis historical perspective

Histoplasma capsulatum was first described by Samuel Taylor Darling in 1906, who coined the term to describe the “plasmodium-like” organisms in the histocytes. In 1912, Henrique da Rocha-Lima, a Brazilian tropical disease specialist, reported findings from a comparison between Leishmania and Histoplasma and concluded that Histoplasma more closely resembled a yeast than a protozoan. In the late 1940s, William A. DeMonbreun, the first person to culture the organism, suggested that the disease may be prevalent in the United States due to mild and carrier forms.^[1]

• Histoplasma capsulatum was first described by Samuel Taylor Darling, an American pathologist, during his work in the Panama Canal Zone.^[2]
• He observed an organism in a patient’s autopsy material that resembled Leishmania and at that time, he falsely identified it as a protozoa.
• The patient died of a generalized disease associated with hepatosplenomegaly and anemia, a syndrome similar to the findings of Leishman and Donovan.
• Despite his very crude equipment by modern standards, Darling was able to identify these “plasmodium-like” organisms in histiocytes, hence coining the name Histoplasma.
• The term “capsulatum” stemmed from Darling’s false assumption that the organism has a capsule.^[1]

• In 1912, Henrique da Rocha-Lima, a Brazilian tropical disease specialist, reported findings from a comparison between Leishmania and Histoplasma and concluded that Histoplasma more closely resembled a yeast than a protozoan.
• Up until the early 1940s, histoplasmosis was considered a fatal tropical disease not prevalent in the United States.
• Dr. Charles E. Smith was the first person to suggest that the rise in pulmonary calcifications in patients with a negative tuberculin test could be due to Histoplasma.^[1]

• In 1928, Dr. Edna H. Tompkins identified the first case of histoplasmosis by demonstrating the organism on the blood smear.
• In 1933, Dr. William A. DeMonbreun of Vanderbilt University became the first person to successfully culture Histoplasma capsulatum species from the same patient identified by Dr. Tompkins.
• Dr. DeMonbreun also fulfilled Koch’s postulates after he injected the culture material into animals.
• He also suggested that the disease may not be as low in prevalence as initially hypothesized due to mild and carrier forms.
• In 1948, Dr. Chester W. Emmons isolated and cultured Histoplasma capsulatum from a soil sample for the first time.^[1]

• Johnny Cash included a reference to the disease, and correctly noted its source in bird droppings, in the song “Beans for Breakfast”.
• Bob Dylan was hospitalized due to histoplasmosis in 1997, causing the cancellation of concerts in the United Kingdom and Switzerland.
• In the episode Family, episode 21 of season 3 of the television show ‘House, M.D.’ a patient was diagnosed with histoplasmosis.