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It's well known that exposure to bats or their droppings during cave exploration (spelunking) can cause acute pulmonary histoplasmosis. In an extended family of 13 whose members lived in 3 U.S. states, 12 spelunked in the Venado Caves of Costa Rica during December of 2024.
All 12 spelunkers developed mild-to-moderate respiratory and gastrointestinal symptoms within 19 days after exploring the caves. Six received treatment (3 with antibiotics, 2 with steroids, and 1 with cough suppressant). A travel history later elicited by an ID specialist yielded the correct etiology. Ultimately, histoplasmosis was categorized as confirmed in 1 family member, probable in 8, and suspected in 3.