Subclinical Histoplasmosis

Studies during the past decade by Palmer and his associates of the United States Public Health Service1and by Christie and his associates at Vanderbilt University2have suggested that many children with pulmonary calcifications and negative tuberculin and positive histoplasmin sensitivity reactions have had a subclinical infection by Histoplasma capsulatum. Further studies by the same and other investigators have established histoplasmosis as a common benign disease of childhood of worldwide distribution, most prevalent in the central United States bordering the confluence of the great midcontinental rivers.3It has further been postulated that approximately half of those reacting to histoplasmin and showing no pulmonary calcification have had the disease without demonstrable pulmonary involvement.3g, j Gastrointestinal histoplasmosis as a part of the generalized fatal disease was almost uniformly present in the 71 cases reviewed by Parsons and Zarafonetis4and in 13 of the 21 cases in children