In January 1906, Strong1 described an ulcerative cutaneous lesion which simulated the Delhi boil. His patient was a Filipino woman 35 years of age. Biopsy revealed that the tissues surrounding the lesion contained macrophages which were filled with parasites, resembled "cockle shells" and measured 3 to 4 microns in diameter. He expressed the opinion that the parasites belonged to the Blastomyces group of organisms and that they had not been described previously.
Although this has been stated to be the first case of histoplasmosis reported in the literature,2 Strong himself stated (in a personal communication to Parsons) that he was of the opinion that this case was an instance of infection in man by Cryptococcus farciminosus. In April 1906, Darling3 reported from the Canal Zone his first case of what he called "a protozoan infection producing pseudotubercles in the lungs and focal necrosis in the liver, spleen
ALEXANDER M. IAMS, MAX M. TENEN, HAROLD F. FLANAGAN. HISTOPLASMOSIS IN CHILDRENREVIEW OF THE LITERATURE, WITH REPORT OF A CASE. Am J Dis Child. 1945;70(4):229–240. doi:10.1001/archpedi.1945.02020220030006