Erythema nodosum in an epidemic of histoplasmosis in Indianapolis.

Eleven patients seen at the Indiana University Medical Center and the Indianapolis Veterans Administration Hospital had erythema nodosum complicating a histoplasmosis infection. A massive, severe outbreak of histoplasmosis occurred in Indianapolis between September 1978 and August 1979. Four hundred thirty-five laboratory-confirmed cases were reported, although serologic findings suggested that from 20,000 to 200,000 persons were actually infected. During this epidemic, 18 (4.1%) of 435 patients were initially seen with erythema nodosum. Ten of 11 patients seen at the Indiana University Medical Center were women, and nine of 11 patients were seen during the first half of the epidemic; race was not a predisposing factor. Seven of 11 patients had respiratory or rheumatologic complaints. None of these 11 patients had evidence of dissemination, died, or required specific antifungal treatment.