Disseminated Histoplasmosis in the Acquired Immune Deficiency Syndrome

[ill]atients with acquired immune deficiency syndrome (AIDS) are susceptible to infection with a [ill]riety of opportunistic pathogens. Pneumocystis [ill]inii pneumonia is the major opportunistic infec[ill]n associated with the syndrome, while Candida[ill]icans and Cryptococcus neoformans are the most [ill]mmon fungi causing disease in AIDS.¹ We first [ill]spected that AIDS predisposed to disseminated [ill]toplasmosis in a patient we examined in 1981.² [ill]ce then, the association has been clearly established, with 15 cases reported in six US cities^3-7 and in Trinidad.⁸ Only one of these occurred outside an endemic area.⁶ Of 19 patients with AIDS examined by either Bonner and co-workers³ in Birmingham, Ala, in this issue (four patients) or by Zeckel et al (unpublished observations) in Indianapolis (15 patients), ten patients (53%) had disseminated histoplasmosis, clearly demonstrating the prevalence of this opportunistic infection in patients with AIDS residing in endemic areas. Early localization of AIDS to New York City and San Francisco