Case history
Case history
A 40-year-old man presents with a 3-week history of fever, headache, dry cough, pleuritic chest pain, and poor appetite. He does not report hemoptysis or dyspnea. His review of systems is otherwise unremarkable. He lives in Ohio and is an archaeologist. He has no sick contacts and cannot recall any specific exposures. His symptoms developed 2 weeks after he had worked on a local excavation project in the Ohio River valley.
Other presentations
Acute pulmonary histoplasmosis may be associated with symptoms resulting from complications including pleural effusions, cavitary disease, pericarditis, arthritis/arthralgia, erythema nodosum, or erythema multiforme. Hematogenous dissemination of the infection can lead to a variety of extrapulmonary manifestations including skin lesions, hepatosplenomegaly, abnormal liver function tests, pancytopenia, gastrointestinal involvement, or a sepsis-like syndrome.[2] Central nervous system dissemination of the disease may present as a brain lesion or as meningitis.
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