Human infection with the pathogenic fungus Histoplasma capsulatum produces diverse clinical manifestations, ranging from an influenza-like illness to a cavitary lung disease to lifethreatening dissemination affecting multiple major organ systems [1, 2]. Long considered to be an infection endemic to the midwestern and southeastern United States and Central and South America [3, 4], new epidemiological reports indicate that other areas of the world, and the US for that matter, have indigenous cases. There is increasing recognition of histoplasmosis in China, particularly along the Yangtze River [5, 6], and numerous case reports are emerging from India [7]. In the US, the recent description of cases from Montana suggests that H. capsulatum is wider spread than originally considered.