IT IS now recognized that in over 95% of cases the primary infection with histoplasmosis is subclinical or else presents as a mild respiratory illness.1 Calcified splenic and hepatic granulomas show that miliary spread from the primary complex often occurs,2 but progression to a clinically disseminated and debilitating infection is extremely rare. Recent evidence indicates that most clinically apparent cases of histoplasmosis in adults are the result of exogenous reinfection.3 These reinfections are usually mild self-limited illnesses, but progression into a chronic disorder mimicking tuberculosis can occur, and dissemination may be a complication. Although the majority of cases of reinfection histoplasmosis present as pulmonary syndromes, the dominant manifestations may in a minority of cases involve other organ systems. When such is the case, histoplasmosis is seldom suspected, as was well illustrated in a recent study of gastrointestinal histoplasmosis at this institution.4 Mucosal involvement is not uncommon in both acute and
Bennett DE. Histoplasmosis of the Oral Cavity and Larynx: A Clinicopathologic Study. Arch Intern Med. 1967;120(4):417–427. doi:10.1001/archinte.1967.04410010031004
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