Acute diffuse pulmonary histoplasmosis with severe disease

• 50 YO Spanish Speaking male
  • presents with fever, abdominal pain, nausea, SOB for 3 weeks since trip to El Salvador
  • Exposure to dirty environment
  • found to have multifocal PNA and acute hypoxemic respiratory failure requiring MICU admission for max doses of high flow NC. G
  • acute bilateral PE without evidence of RHS so was started on anticoagulation. A
  • infectious studies
    • positive histoplasmosis, s
    • started on amphotericin
    • transitioned to itraconazole