The systemic fungus diseases of man have recently come into prominence as widespread common problems, rather than rare and fatal diseases. Indeed, the clinical picture of these diseases is still evolving, as is shown by an article on page 109 of The Journal, which reports the widespread prevalence of positive serologic tests for histoplasmosis in patients in tuberculosis sanatoria in the United States. Based on evidence obtained from almost 45,000 screen tests already performed, it is estimated that some 8,000 patients with positive serologic tests for histoplasmosis may have been admitted to sanatoria during the year 1959. Based on experience in one sanatoria, at least one-fourth of patients with positive serologic tests can be proved by adequate culture methods to have active histoplasmosis.
The evidence is slowly being unraveled as to similarities and differences among the 4 most prominent granulomatous diseases, namely, tuberculosis, coccidioidomycosis, histoplasmosis, and blastomycosis. The skin test