Nelson Textbook of Pediatrics 22nd Edition | Endemic in Ohio and Mississippi River valleys (US), Central/South America. Acute pulmonary histoplasmosis (often asymptomatic, flu-like), progressive disseminated histoplasmosis (PDH) in immunocompromised (HIV, transplant, TNF inhibitors). Diagnosis: urine/serum antigen (sensitive), complement fixation, immunodiffusion, culture. Treatment: itraconazole (mild-moderate), amphotericin B (severe, disseminated, meningitis).
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