Disseminated histoplasmosis in dialysis patients.

The unusual occurrence of disseminated histoplasmosis in two dialysis patients residing in a nonendemic area is described; one on chronic hemodialysis, the other on continuous ambulatory peritoneal dialysis (CAPD). They both presented with nonspecific febrile illness with splenomegaly and/or pancytopenia. Rapid diagnosis was made with bone marrow biopsies and cultures. In the second patient, peritonitis secondary to histoplasmosis was documented by culture of the dialysate and at autopsy. This is the first such description in a CAPD patient.