Infection with the fungus Histoplasma capsulation , especially common in North and Central America and in many South American countries, and introduced to Western Europe from these countries. In America more than half a million people are infected each year, half of whom display no symptoms. The fungus lives in soil fouled with chicken, bird or bat droppings, and inhalation of the fungal spores can cause infection in man, particularly in the lungs. The infection can cause a clinical picture similar to influenza or pneumonia. Coughing, constriction, chest pain, hoarseness and fever are the major symptoms. In some patients the fungus spreads throughout the body, a serious condition with a high death rate. If centred in the lung it can be removed by surgery. In some cases medication is necessary.