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December 1951

HISTOPLASMIN SENSITIVITY IN THE PANAMA CANAL ZONE: A Correlated Clinicopathologic Study of One Thousand Patients, with Speculations as to the Present Status of Histoplasma Capsulatum on the Isthmus of Panama

Author Affiliations


From the Medical Service, Colon Hospital, Cristobal, C. Z.

AMA Arch Derm Syphilol. 1951;64(6):713-726. doi:10.1001/archderm.1951.01570120048006

BETWEEN December, 1905, and August, 1906, Dr. Samuel Taylor Darling encountered at autopsy at the Board of Health Laboratory, Ancon, C. Z., three cases of a previously undescribed parasitic disease.1 This entity has since become widely known as histoplasmosis (Fig. 1). During the intervening decades, in spite of a high index of suspicion on the part of local clinicians and pathologists, no additional human case has been recognized. The patients described by Darling were immigrants, and there has been justifiable doubt as to whether the fungus, Histoplasma capsulatum, had become established on the Isthmus, even though Tomlinson and Grocott reported a canine infection in 1945, probably autochthonous in origin.2 The prolonged absence of recognized human cases of histoplasmosis in an area in which the causative fungus had certainly been present was a paradox inviting study.

Within the past five years Wedding, Reynolds, and Bashe have each carried out limited studies with the histoplasmin intradermal test