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The Histoplasma capsulatum fungus apparently has moved west of the Ohio River and Mississippi River valleys and now may be endemic in Montana.
Recently in the Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) described 4 unrelated histoplasmosis cases that 4 Montana physicians diagnosed between November 2012 and February 2013. Clinicians should be aware that exposure to H capsulatum may occur in Montana and consider histoplasmosis in patients with pneumonia-like symptoms who live or have traveled there, the CDC advised.
Fungus That Causes Histoplasmosis May Be Endemic in Montana. JAMA. 2013;310(24):2608. doi:10.1001/jama.2013.283906