MICROBIOLOGY AND EPIDEMIOLOGY

• Mycelia are infectious and have microconidial and macroconidial forms. Microconidia are inhaled, reach the alveoli, and are transformed into yeasts with occasional narrow budding. A granulomatous reaction results; in pts with impaired cellular immunity, infection may disseminate.
• Histoplasmosis is the most prevalent endemic mycosis in North America and is also found in Central and South America, Africa, and Asia. In the United States, histoplasmosis is endemic in the Ohio and Mississippi river valleys.
• The fungus is found in soil, particularly that enriched by droppings of birds and bats.