A DNA probe performed on a specimen of early colony growth was positive for Histoplasma capsulatum . Histoplasma antigen was also detected in the urine. His fevers and skin lesions resolved and his thrombocytopenia gradually improved. He was discharged to home and will continue on itraconazole suppressive therapy indefinitely. It is frequently the AIDS-defining illness in patients with HIV infection in these highly endemic regions.
Illness can be acutely life-threatening in the disseminated form of the disease.
Although it most commonly presents with respiratory tract symptoms, other organs systems such as bone marrow, gastrointestinal tract, brain, and pericardium are often involved. Although entry of the organism is through the respiratory tract, only about half of AIDS patients with disseminated disease demonstrate abnormalities on chest radiograph. Lesions are more likely to occur on exposed parts of skin as the organism grows better at room temperature. Enlargement of the liver and spleen along with bone marrow suppression are common findings as well. Diagnosis can be made by biopsy and visualization of yeast forms by silver stain.