Disseminated Histoplasmosis in the Acquired Immune Deficiency Syndrome

[ill]atients with acquired immune deficiency syndrome (AIDS) are susceptible to infection with a [ill]riety of opportunistic pathogens.Pneumocystis [ill]iniipneumonia is the major opportunistic infec[ill]n associated with the syndrome, whileCandida[ill]icansandCryptococcus neoformansare the most [ill]mmon fungi causing disease in AIDS.1We 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 cities3-7and in Trinidad.8Only one of these occurred outside an endemic area.6Of 19 patients with AIDS examined by either Bonner and co-workers3in Birmingham, Ala, in this issue (four patients) or by Zeckel et al (unpublished observations) in Indianapolis (15 patients), ten patients (53%) had disseminated histoplasmosis, clearly demonstrating the prevalence of this opportunistic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