Histoplasmosis presenting as pneumoperitoneum in patients with acquired immune deficiency syndrome: case reports and review of the literature.

Histoplasmosis is a rare, but important, disease process in patients with the acquired immune deficiency syndrome (AIDS). Initially reported in this patient population in 1982, over 100 cases of histoplasmosis have been reported throughout the United States. Most of these patients present with disseminated disease. Untreated, histoplasmosis will be the direct cause of death in over 80% of patients, but treatment with itraconazole can reduce this mortality to less than 25%. We present two cases of histoplasmosis in AIDS patients presenting as pneumoperitoneum.