Histoplasmosis can present in a variety of ways, making it difficult to diagnose. Dr Staffolani and colleagues carried out a systematic review of 835 cases of histoplasmosis (including 45 clusters) from the literature, among immunocompetent patients who had recently returned from an endemic area. Manifestations included fever (91%), cough (55%), constitutional symptoms (58%), headache (52%) and chest pain (41%).
Cryptococcosis is well known as a complication of HIV/AIDS, but it can also affect those who are immunosuppressed for other reasons. Dr Marr and colleagues describe a set of 138 patients from the US. Around half (49%) had CNS involvement but only just over a quarter (27.8%) had a fever.