primary pulmonary histoplasmosis - this is usually asymptomatic. Often the only evidence of infection is a positive histoplasmin skin test. If the primary pulmonary infection is symptomatic then it may present with an influenza-like illness, with fever, chills, myalgia and cough. Complications such as atelectasis and secondary bacterial pneumonia may occur. Other conditions that may be associated with this condition include pleural effusions, erythema nodosum and erythema multiforme. In primary pulmonary histoplasmosis the radiological changes are similar to those seen in primary tuberculosis with a primary Ghon focus. In patients where there is high endemicity there may be calcification in the lungs, spleen, and liver.
chronic pulmonary histoplasmosis - this condition is clinically indistinguishable from pulmonary tuberculosis. This condition is usually seen in white males over the age of 50 years. On X-ray there is often seen pulmonary cavities, infiltrates and characteristic fibrous streaking from the periphery towards the hilum.
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