Progressive Disseminated Histoplasmosis

Abstract

The clinical, laboratory, and histopathologic features of progressive disseminated histoplasmosis in 26 patients were studied prospectively. The diagnosis was proved by culturing the fungus from bone marrow and blood, in most cases, or by culturing tissues such as oral lesions, lymph nodes, or liver. Serologic studies and skin testing were considerably less valuable. Liver involvement was a prominent feature in most cases. Hematologic abnormalities (anemia and thrombocytopenia) and pulmonary abnormalities were present in half the patients, and renal abnormalities and oral mucosal lesions were present in slightly less than half. Less common manifestations included meningitis, endocarditis, adrenal insufficiency, and gastrointestinal and cutaneous lesions. Amphotericin B was an effective agent in most patients, but relapses of infection occurred in half of those with favorable response.