TY - CHAP M1 - Book, Section TI - Histoplasmosis A1 - Raffanti, Stephen P. A1 - Person, Anna K. A2 - Knoop, Kevin J. A2 - Stack, Lawrence B. A2 - Storrow, Alan B. A2 - Thurman, R. Jason PY - 2021 T2 - The Atlas of Emergency Medicine, 5e AB - Disseminated histoplasmosis most commonly occurs in immunocompromised patients living in the Ohio and Mississippi River Valleys. HIV-infected patients with disseminated histoplasmosis usually have a CD4 count <200 cells/mm3 and present with fever, weight loss, malaise, and pulmonary symptoms such as cough and dyspnea. Pulmonary symptoms predominate, and in severe cases, patients may present with acute respiratory distress syndrome. Patients may present with a diffuse papular rash in disseminated disease. Mediastinitis is a rare but serious complication of histoplasmosis. Urine and serum antigen testing carries a high sensitivity, but bronchoalveolar lavage may be needed to make the diagnosis in cases of pulmonary involvement. Serum LDH and alkaline phosphatase levels may be markedly elevated as well. SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/04/19 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1181057398 ER -