[Histoplasma capsulatum in the peripheral blood of patients with AIDS. Report of 4 cases with an increase of lactate dehydrogenase].

This paper describes the clinical course of four patients with AIDS who were found to have H capsulatum in peripheral blood. The evolution of the infection was fulminant and all died within the first 96 hours following hospitalization. In every case the presence of the characteristic mycelium and "tuberculate" macroconidia of Histoplasma was established in cultures. All cases showed the hematological abnormalities common in other AIDS associated diseases. In addition, there was an increase in serum lactic dehydrogenase over ten times our normal level: the lowest LDM assay was 2137 IU/mL and the highest 4839 IU/mL. This clinical course resembling septicemia and the demonstration of H capsulatum in a peripheral blood smear has had a rate of 12% in our experience (four out of the 34 cases of AIDS with histoplasmosis seen in our institution from January 1984 to March 1991).