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Disseminated Histoplasmosis in the Acquired Immune Deficiency Syndrome

L. Joseph Wheat, MD; Catherine Butkus Small, MD
Arch Intern Med. 1984;144(11):2147-2149. doi:10.1001/archinte.1984.04400020049006.
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[ill]atients with acquired immune deficiency syndrome (AIDS) are susceptible to infection with a [ill]riety of opportunistic pathogens. Pneumocystis [ill]inii pneumonia is the major opportunistic infec[ill]n associated with the syndrome, while Candida[ill]icans and Cryptococcus neoformans are the most [ill]mmon fungi causing disease in AIDS.1 We first [ill]spected that AIDS predisposed to disseminated [ill]toplasmosis in a patient we examined in 1981.2 [ill]ce then, the association has been clearly established, with 15 cases reported in six US cities3-7 and in Trinidad.8 Only one of these occurred outside an endemic area.6 Of 19 patients with AIDS examined by either Bonner and co-workers3 in Birmingham, Ala, in this issue (four patients) or by Zeckel et al (unpublished observations) in Indianapolis (15 patients), ten patients (53%) had disseminated histoplasmosis, clearly demonstrating the prevalence of this opportunistic infection in patients with AIDS residing in endemic areas. Early localization of AIDS to New York City and San Francisco


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