GOTHAM CITY – Saying that it is pretty remarkable that he even went this long without catching it, doctors at Gotham City Medical Center (GCMC) have diagnosed DC superhero Batman with acute pulmonary histoplasmosis. He has already begun treatment and is expected to survive.
“Mr. Batman has been fighting with multiple symptoms – fevers, chills, fatigue, cough, weight loss, pleuritic chest pain, headache, and myalgias – for over a month now, and his initial chest imaging showed diffuse bilateral reticulonodular infiltrates,” explained Dr. Jennifer Stephens, an infectious diseases physician at GCMC. “When he didn’t respond to usual treatment for community-acquired pneumonia, that’s when the team started looking for alternative causes.”
Histoplasmosis was first described in 1906 by a U.S. Army physician in Panama, and is the result of infection by Histoplasma capsulatum, which is most commonly found along the Ohio & Mississippi River Valleys in the United States. H. capsulatum is found in bird or bat droppings.
As Batman lives in a Batcave, it is no wonder that histoplasmosis moved to the top of the differential for the GCMC medical staff. Fortunately for Batman, despite the numerous symptoms he has been experiencing, he has not had any evidence of respiratory failure or ARDS. He also hasn’t had any evidence of disseminated disease including pericarditis or arthritis.
The Caped Crusader eventually underwent bronchoscopy, and both bronchoalveolar lavage cultures and histopathologic examination confirmed the presence of H. capsulatum. He was started on itraconazole and plans to complete a 6-to-12 week course. His medical team advised Batman to focus on rest and recuperation during this time period, and defer defeating evildoers to his other brethren in the DC Universe.
Batman is expected to make a full recovery, but he is not leaving anything to chance: he has named his butler, Alfred Pennyworth, as his medical power of attorney. Despite having the same exposure as Batman, Alfred has thankfully shown no signs of pulmonary or disseminated histoplasmosis.
“You really scared me, Master Bruce,” Alfred was overheard telling Batman, who remains in his usual mask and cape, unwilling to trade them in for a hospital johnny. “If you had died, who employs butlers anymore?”