Cellular immunity is usually depressed during infection and it may, in part, be caused by the fungus itself. Pulmonary involvement is characterized by a low frequency of respiratory symptoms, in spite of the extensive radiological involvement. Lymph node are compromised more importantly than is the pulmonary parenchyma. Pleural involvement is not common. Lymphatic involvement is common and it may actually be the only complaint, mostly in the juvenile form.
Cephalic lymphs are more involved.
These lymph nodes may be suppurative inflammatory or non-suppurative. The upper respiratory tract may be involved and it may allow collection of diagnostic material. The central nervous system can be involved. Usually, these patients have a history of previous involvement of other organs. These lesions frequently work as a tumoral lesion but it can also be a meningeal type.