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Rheumatologic symptoms can occur in histoplasmosis

Phil Gunby
JAMA. 1980;244(18):2020. doi:10.1001/jama.1980.03310180004002.
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Nearly 7% of one patient group treated during Indianapolis' 1978-1979 histoplasmosis outbreak had rheumatologic manifestations, such as arthritis, arthralgia, or erythema nodosum.

In reporting this to the American Rheumatism Association section at the Arthritis Foundation's annual meeting in Atlanta, Indiana University Medical Center investigators noted: "In most patients, the rheumatologic manifestations were sufficiently mild as to require no therapy or only salicylates or other nonsteroidal anti-inflammatory drugs. However, three patients were given prednisone."

The Indianapolis outbreak claimed 15 lives. Before it subsided, 435 histoplasmosis cases were confirmed serologically. The source never was found (JAMA [MEDICAL NEWS] 1979;242:1010 and 1980;243:1130).

The investigators—Jerome Rosenthal, MD, Kenneth D. Brandt, MD, Lawrence J. Wheat, MD, and Thomas G. Slama, MD—obtained their information from a review of the records of 381 patients "with symptomatic histoplasmosis infections" seen during the outbreak. Twenty-four (6.6%) of these patients had rheumatologic problems: Sixteen had joint pain without swelling (classified


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