Histoplasmosis; three fatal cases with disseminated sarcoid-like lesions.

Abstract

THE THREE fatal cases of histoplasmosis with disseminated sarcoid-like lesions which are reported in this paper serve as evidence for the view that subacute or chronic histoplasmosis may, in some instances, exhibit certain clinical and pathologic features often regarded as diagnostic of sarcoidosis. In recent years it has become clear that the clinical manifestations evoked by Histoplasma capsulatum are as protean as those of tuberculosis. Histoplasmosis may be localized or generalized; often it is localized for months or years, eventually becoming generalized. It may be acute, subacute, recurrent, or chronic, and it may be severe, mild, or completely asymptomatic. 1 Almost any organ or tissue may be involved, but lesions are most frequently seen in the lungs, lymph nodes, spleen, liver, intestine, adrenal glands, bone marrow, skin, and naso-oral cavity. The lesions of histoplasmosis are almost as varied as the clinical picture. They show every gradation of granulomatous reaction from