Table 2.

Key features of pulmonary histoplasmosis.

Clinical Form
Characteristic	Acute	Subacute	Nodular	Chronic Cavitary
Age	Any	Any	Any	>50-year-old with structural lung disease
Clinical manifestation	Fever, headache, dry cough, chills, chest pain, malaise, myalgias and arthritis	Same as acute but symptoms are milder	Usually asymptomatic	Fever, productive cough, dyspnea, weight loss, hemoptysis, night sweats, chest pain
Symptom duration	1–2 weeks	Weeks to months	-	Months to years
Mimicked disease	Community acquired pneumonia	Community acquired pneumonia	Neoplasm	Tuberculosis, Sarcoidosis
Pathology	Granuloma with acute lung injury	Well-formed granulomas	Well-formed granulomas	Cavities with granulomas, tissue destruction
Radiologic findings	Diffuse bilateral patchy opacities	Focal or patchy opacities	Nodules	Cavitation, fibrosis, volume loss, pleural thickening. Right upper lobe is most commonly affected
Hilar and Mediastinal lymph nodes	Enlarged	Enlarged	Not enlarged	Not enlarged. Occasionally calcified
Calcifications	None	None	Present	Present
Indications for treatment	Severe disease	Symptoms over 1 month	None	Yes