Background: Opportunistic infections, while well studied in the AIDS population, continue to have variable and\nsurprising presentations. Here, we present a case of disseminated histoplasmosis with disseminated nontuberculous\nmycobacterial infection in a 50 year old man with long standing AIDS living in a non-endemic area.\nCase presentation: Patient presented with a constellation of symptoms, and imaging of the chest showed a\npulmonary mass with cavitation, multiple nodules, and ground glass opacities. Further investigations revealed\ngranulomatous lung nodules and fungemia consistent with Histoplasma capsulatum, and coinfection with\ndisseminated nontuberculous mycobateria in a nonendemic area.\nConclusions: Immunocompromised patients risk co-inhabitation by multiple infectious organisms. Some of these\norganisms may preside in the host for years prior to reactivation. Clinicians in non endemic areas should therefore\nbe careful to not overlook specific organisms based on a lack of a recent travel history. Physicians in nonendemic\nareas should become more familiar with the clinical findings and diagnostic approach of infectious such as\nHistoplasmosis, to ensure earlier recognition and treatment in immunocompromised individuals.
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