Most people who are infected with H. capsulatum do not experience any symptoms of disease. If the infection causes active disease, symptoms can include fever, weight loss, skin lesions, breathing difficulties, chest pain, nonproductive (dry) cough, anemia, and enlargement of the liver, spleen, and lymph nodes. The higher the CD4 cell count, the more likely it is that histoplasmosis will only involve the lungs; the lower the CD4 cell count, the more likely it is that H. capsulatum will cause disease in other parts of the body, including the central nervous system (meningitis). More rarely, people can experience shock and multiple organ failure.
The most effective way to diagnosis this infection is to collect sputum (phlegm), blood, or bone marrow samples. Once these fluids have been collected, a laboratory will attempt to grow the fungus in test tubes or to look for the fungus under a microscope. It is also possible to look for a H. capsulatum antigen—a key fragment of the fungus—in blood and urine samples.
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