DISSEMINATED histoplasmosis is often suspected in an infant presenting with pallor, pulmonary disease, hepatosplenomegaly, gastrointestinal symptoms, and irregular spiking temperature. However, confirmation of the diagnosis is often delayed as skin tests may be negative early in the disease and in overwhelming infection a morphologic identification of the causative organism may be difficult, culture results may require weeks, and frequently serum must be shipped to distant centers for complement-fixation titers.1-7 Further clinical and laboratory information is obviously needed to permit early diagnosis of this infection in infancy.
This report describes in detail the clinical manifestations, hematologic, histochemical, and immunologic data, in four infants from 2 to 6 months of age with disseminated histoplasmosis. The presence of a positive histoplasmin precipitin test and the identification of Histoplasma capsulatum in the bone marrow or percutaneous liver biopsy specimens offered the earliest means of diagnosis in these infants. Recognition of the yeast-phase of