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August 9, 1947

HISTOPLASMOSISA Review of the Cutaneous and Adjacent Mucous Membrane Manifestations with a Report of Three Cases

JAMA. 1947;134(15):1217-1224. doi:10.1001/jama.1947.02880320007003

Histoplasmosis has been considered, until recently, an extremely rare disease of tropical origin, but in the current literature there has been a geometric increase of case reports. Most cases of histoplasmosis have been systemic and generalized, but involvement of the skin and nearby mucous membrane is common, and there is evidence that the disease may be local as well as generalized.

Darling1 described the first 3 cases of histoplasmosis in Panama; hence the tropical connotation long attached to the disease. He did not suspect that the etiologic agent was a fungus but believed the organism to be protozoan in nature. Da Rocha-Lima,2 who studied Darling's microscopic sections in 1913, was the first to suggest a yeastlike fungus as the cause of the disease; but confirmation of the correct etiology was not forthcoming until 1934, when De Monbreun3 cultured the fungus from the blood and spleen of an

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