Acute Pulmonary Histoplasmosis on the Isthmus of Panama

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Abstract
A benign form of histoplasmosis was established by Palmer 1 and by Christie and Peterson,2 in 1945, by a correlation between pulmonary calcifications and histoplasmin skin test, and by other investigators, later, by the demonstration of elevated antibody levels during an acute pulmonary illness.3 In only a few cases of this entity has Histoplasma capsulatum been isolated from the patient. On the Isthmus of Panama, however, where in its fatal form the first three cases of the disease were described by Darling,4-6 in 1905, the benign form of histoplasmosis has not been described. Even the fourth fatal case studied by Draheim et al.7 was not encountered until 1951. This finding of only the rare fatal cases of histoplasmosis in a large population with a high skin-test-reaction rate to histoplasmin and closely associated with soil which is known to harbor the causative agent indicates that the primary

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