CDC

CDC investigates histoplasmosis outbreak tied to Costa Rica cave tour

May 22, 2025

CDC has reported a cave-associated histoplasmosis outbreak among 12 members of an extended family from Georgia, Texas, and Washington who traveled to Costa Rica in December 2024. All 12 individuals—six adults and six children—developed symptoms consistent with histoplasmosis 8 to 19 days after touring Venado Caves, a known site of prior fungal outbreaks linked to bat guano exposure. One family member who didn’t enter the cave remained asymptomatic.

Symptoms included fever, malaise, headache, myalgias, and respiratory and GI symptoms. Five adults and one child sought medical care; three were initially treated with antibiotics, and two received corticosteroids, which may worsen fungal infections. One adult required hospitalization and antifungal therapy. Laboratory testing confirmed Histoplasma infection in two individuals via antigen testing, with one also antibody-positive. All affected individuals had recovered or were improving by late January 2025.

This is the second reported outbreak linked to Venado Caves, underscoring the ongoing risk of Histoplasma exposure in bat-inhabited environments. Clinicians should consider histoplasmosis in patients with compatible symptoms and recent travel to endemic areas, particularly those involving cave exploration.

Source:

(2025, May 15). CDC. Cave-Associated Histoplasmosis Outbreak Among Travelers Returning from Costa Rica — Georgia, Texas, and Washington, December 2024–January 2025. https://www.cdc.gov/mmwr/volumes/74/wr/mm7417a1.htm