Pulmonary histoplasmosis

A woman of 55, who lived in Ohio from 1926 to 1934, and has since lived in Lancashire, was found to have scattered infiltrates and fibrotic changes throughout both lungs, associated with a strongly positive histoplasmin test. She died of cor pulmonale after many years of respiratory crippling: pathological examination of the lungs showed gross fibrosis with emphysema. Her husband, who lived in Ohio for a similar period, has scattered calcified opacities in the right lung, with a calcified hilar gland, and a violently positive histoplasmin test. He is entirely free of symptoms. The possibility is presented that these radiological changes are consequent upon infection with Histoplasma capsulatum acquired during the patients' residence in the United States. The extensive studies of this disease in the United States during the last ten years, arising from the importance there of pulmonary histoplasmosis in the differential diagnosis of tuberculosis, are briefly reviewed.