The spectrum of illness associated with disseminated histoplasmosis ranges from an acute, rapidly fatal infection, usually in infants and severely immunocompromised individuals, to a chronic, intermittent course in immunocompetent individuals. In immunocompromised patients, fever is the most common symptom. These patients may present with weight loss, anorexia, malaise, cough, nausea, vomiting, diarrhea, and abdominal pain. On physical examination, patients may have adenopathy, hepatosplenomegaly, oral ulcers, and, less commonly, a maculopapular rash.2 Patients with AIDS may develop disseminated intravascular coagulation, hypotension, and meningitis. Laboratory evaluation may reveal pancytopenia and abnormal liver function test results due to involvement of the bone marrow and liver. In contrast, in immunocompetent patients, the symptoms are typically mild and intermittent, including low-grade fever, weight loss, and fatigue. Hoarseness, oropharyngeal ulcers, hepatosplenomegaly, and adrenal insufficiency may occur.