In 1956 we discussed the history of histoplasmosis1 and the developments of 50 years since the discovery of the disease by Samuel T. Darling.2 Since 1956, much new knowledge has accumulated—an effective therapeutic agent (amphotericin B) has become available,3 and essential epidemiologic and anatomical data have been brought forward contributing to the understanding of the disease.
It is universally accepted that the lung is, for all practical purposes, the only portal of entrance for the cells of Histoplasma capsulatum and the site of the primary infection. This statement is based on the demonstration of primary foci in the lungs of a large segment of the population in the endemic area by anatomical methods with demonstration of organisms in these frequently calcified, primary lesions.4-8
Epidemiologic studies have been another source of information contributing to this pathogenic opinion. Furcolow and others9,10 have shown that the so-called epidemics