Abstract
In the Ohio, Missouri, Mississippi, and St Lawrence River valley basins,1,2 up to half the population may show evidence of Histoplasma capsulatum.3 In apparently healthy persons, most infections are asymptomatic or clinically self-limited. Less often, healthy individuals who are infected may experience severe, progressive disseminated disease.4,5 Various acute and chronic manifestations may result from unusual inflammatory or fibrotic responses to histoplasmosis. These include pericarditis and rheumatologic syndromes, chronic mediastinal inflammation or fibrosis, complete or partial pulmonary artery obstruction as a result of extrinsic compression, broncholithiasis, and enlarging parenchymal granulomas.
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