[Diagnostic approach to disseminated histoplasmosis]

Disseminated histoplasmosis is a condition with nonspecific clinical signs. In case of fever in a patient receiving anti-TNF alpha therapy, a thorough history that includes travel to areas of high endemicity can raise suspicion of infection. When suspected, diagnosis is made by detecting antigens in urine and blood (if this analysis is available), conducting serology, and obtaining a specimen for culture, direct microscopy, and histopathological analysis. PCR for Histoplasma can also be performed. When treatment is initiated early, the outcome is favourable in the vast majority of cases. Treatment requires intravenous administration of amphotericin B followed by oral itraconazole.