University of Minnesota Medical School research team awarded 7-year, $9.1 million NIH grant to improve treatment of fungal infection

MINNEAPOLIS/ST. PAUL (10/02/2025) — A new clinical trial is in the works at the University of Minnesota Medical School to improve the treatment of a fungal infection known as histoplasmosis with a new seven-year, $9.1 million grant from the National Institutes of Health.

Histoplasmosis is estimated to affect over half a million people in the U.S. alone and is as common — and more deadly — than tuberculosis in people with HIV in Latin America. Histoplasmosis can cause a wide variety of symptoms, from a mild respiratory illness to a life-threatening disseminated infection. The most severe forms primarily affect people with weakened immune systems, but they can also strike those without any immune system issues. 

“Histoplasmosis occurs right here in Minnesota and across the world, and is much more common than most people realize,” said Nathan Bahr, MD, FIDSA, an associate professor at the University of Minnesota Medical School. “This will be the largest clinical trial for persons with histoplasmosis ever done and will examine every facet of the treatment of histoplasmosis. If successful, our trial will completely change how severe histoplasmosis is treated around the world.” 

The study will enroll over 600 patients across Brazil and in Kansas City, making it the largest trial of its kind. It will be co-led by Dr. Bahr and Dr. Alessandro Pasqualotto at Universidade Federal de Ciencias da Saude de Porto Alegre in Brazil. The University of Minnesota Medical School team will coordinate numerous elements of the trial, including data collection and analysis, drug procurement and quality control. Researchers will test new approaches to both the intensive initial phase of treatment and the longer follow-up phase that helps prevent the infection from coming back. 

Currently, patients undergo a two-week treatment with a strong antifungal medication, followed by a year of milder antifungal medications. This trial will explore three key questions:

• Is a single, high dose of the antifungal medication liposomal amphotericin B just as safe and effective as the current two-week medication?
• Can an alternative antifungal medication, posaconazole, replace and be as effective and safe as the standard follow-up treatment, itraconazole
• Do patients with HIV truly need 12 months of therapy, or could six months work just as well?

In addition to this trial, Dr. Bahr has also been awarded a second NIH grant, a four-year $3 million project to improve the diagnosis of recurrent cryptococcal meningitis, another deadly fungal infection. The project will test a same-day diagnostic tool to quickly identify whether symptoms are caused by a relapse of the disease, aiming to speed up treatment decisions and improve patient outcomes. 

According to the research team, the study’s results could reshape global treatment standards and lead to faster and safer recovery for patients. They plan to use the trial’s network to study additional therapies, further advancing care for histoplasmosis disease. 

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