A 42-year-old poultry farmer was admitted to the hospital. During the previous two months, he had a cough, slight pain in the anterior part of the left side of the chest, and dyspnoea on exertion. He had lost 20 pounds. The results of the physical examination were not significant.
Roentgenographic examination disclosed fibrous and nodular infiltration in the upper third of both lungs. Planography revealed several translucent areas which appeared to represent cavities. Calcified nodules were seen in the hilar region and both lung fields. Three cultures of the sputum were positive. For Histoplasma capsulatum, and three were negative for acid-fast bacilli. The histoplasmin skin test and the Mantoux test* were both positive. A complement-fixation test with H. capsulatum antigen was positive with a high titre, 1:128. The sedimentation rate of the erythrocytes (Wintrobe’s method) was 35 mm. in one hour. The albumin-globulin ratio of the serum was reversed, and moderate anaemia was present. Fungicides did not have any definite effect. The patient was observed for 12 months. He became asymptomatic except for slight dyspnoea, which occurred due to exertion, and he gained 27 pounds. Cultures of the sputum became negative for H. capsulatum, and roentgenographic examination revealed that the lungs were becoming clear.
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