Suspect histoplasmosis in returning travellers from an endemic area presenting with fever and cough

Histoplasmosis can present in a variety of ways, making it difficult to diagnose. Dr Staffolani and colleagues carried out a systematic review of 835 cases of histoplasmosis (including 45 clusters) from the literature, among immunocompetent patients who had recently returned from an endemic area. Manifestations included fever (91%), cough (55%), constitutional symptoms (58%), headache (52%) and chest pain (41%).

Oropharyngeal histoplasmosis: a manifestation of disseminated disease

Histoplasmosis is a fungal infection endemic to areas of Central America and Midwest USA. Most people develop a mild form of infection and are asymptomatic; if symptoms do occur they are usually flu-like, but can vary greatly. In a few, usually immunosuppressed, patients the disease can progress to life-threatening, disseminated histoplasmosis. Dr Thais Pincelli and colleagues recently reviewed all 10 cases of oropharyngeal histoplasmosis identified over a 21 year period at the Mayo Clinic in Rochester, Minnesota.

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