The lungs are the portal of entry for this infection. Histoplasma grows as a mold in soil and infection results from inhalation of airborne fungal particles. Soil contaminated with bird or bat droppings may have a higher concentration of mold.

Histoplasmosis may have no symptoms, there may be a short period of active infection or it can become chronic and spread throughout the body. Most patients with symptomatic histoplasmosis will have a flu-like syndrome and pulmonary (lung) complaints related to underlying pneumonia or other lung involvement. Individuals with chronic lung disease (e.g., emphysema, bronchiectasis) may be at higher risk of a more severe presentation. If the body responds to infection with extreme inflammation, up to 10% of patients may have inflammatory complications involving the skin, bone/joints or the lining of the heart (pericardium).

In a small proportion of patients, histoplasmosis may be widespread (disseminated histoplasmosis) and involve the blood, meninges, adrenal glands and other organs. Very young or very old people or those who have underlying immune disorders such as AIDS are at higher risk for disseminated histoplasmosis.

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