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|000023a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000023b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00003e50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003e60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003e70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003e80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003e90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
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|00003eb0| 6c 75 69 64 20 41 62 6e | 6f 72 6d 61 6c 69 74 69 |luid Abn|ormaliti|
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|00004000| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004010| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004020| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004030| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004040| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
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|00004fd0| 49 44 53 0d 0a 0d 0a 2d | 2d 2d 2d 2d 2d 2d 2d 2d |IDS....-|--------|
|00004fe0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004ff0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005000| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005010| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00005030| 75 73 20 56 61 73 63 75 | 6c 61 72 20 4c 65 73 69 |us Vascu|lar Lesi|
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|00005080| 63 71 75 69 72 65 64 20 | 49 6d 6d 75 6e 6f 64 65 |cquired |Immunode|
|00005090| 66 69 63 69 65 6e 63 79 | 20 53 79 6e 64 72 6f 6d |ficiency| Syndrom|
|000050a0| 65 20 28 41 49 44 53 29 | 20 61 6e 64 20 41 49 44 |e (AIDS)| and AID|
|000050b0| 53 2d 52 65 6c 61 74 65 | 64 20 43 6f 6d 70 6c 65 |S-Relate|d Comple|
|000050c0| 78 0d 0a 0d 0a 4b 6f 65 | 68 6c 65 72 2c 20 4a 45 |x....Koe|hler, JE|
|000050d0| 3b 20 4c 65 42 6f 69 74 | 2c 20 50 45 3b 20 45 67 |; LeBoit|, PE; Eg|
|000050e0| 62 65 72 74 2c 20 42 4d | 3b 20 42 65 72 67 65 72 |bert, BM|; Berger|
|000050f0| 2c 20 54 47 0d 0a 28 55 | 6e 69 76 20 6f 66 20 43 |, TG..(U|niv of C|
|00005100| 61 6c 69 66 6f 72 6e 69 | 61 2c 20 53 61 6e 20 46 |aliforni|a, San F|
|00005110| 72 61 6e 63 69 73 63 6f | 29 0d 0a 41 6e 6e 20 49 |rancisco|)..Ann I|
|00005120| 6e 74 65 72 6e 20 4d 65 | 64 20 31 30 39 3a 34 34 |ntern Me|d 109:44|
|00005130| 39 2d 34 35 35 2c 20 53 | 65 70 74 20 31 35 2c 20 |9-455, S|ept 15, |
|00005140| 31 39 38 38 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1988..--|--------|
|00005150| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005160| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005170| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005180| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005190| 2d 2d 2d 2d 2d 2d 0d 0a | 0d 0a 41 62 73 74 72 61 |------..|..Abstra|
|000051a0| 63 74 0d 0a 0d 0a 20 20 | 20 20 20 48 69 73 74 69 |ct....  |   Histi|
|000051b0| 6f 63 79 74 6f 69 64 20 | 61 6e 64 20 65 70 69 74 |ocytoid |and epit|
|000051c0| 68 65 6c 69 6f 69 64 20 | 68 65 6d 61 6e 67 69 6f |helioid |hemangio|
|000051d0| 6d 61 73 20 61 72 65 20 | 64 65 73 63 72 69 62 65 |mas are |describe|
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|000051f0| 74 68 0d 0a 68 75 6d 61 | 6e 20 69 6d 6d 75 6e 6f |th..huma|n immuno|
|00005200| 64 65 66 69 63 69 65 6e | 63 79 20 76 69 72 75 73 |deficien|cy virus|
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|00005230| 61 63 71 75 69 72 65 64 | 0d 0a 69 6d 6d 75 6e 6f |acquired|..immuno|
|00005240| 64 65 66 69 63 69 65 6e | 63 79 20 73 79 6e 64 72 |deficien|cy syndr|
|00005250| 6f 6d 65 20 28 41 49 44 | 53 29 20 61 6e 64 20 41 |ome (AID|S) and A|
|00005260| 49 44 53 2d 72 65 6c 61 | 74 65 64 20 63 6f 6d 70 |IDS-rela|ted comp|
|00005270| 6c 65 78 20 77 65 72 65 | 20 73 65 65 6e 20 77 69 |lex were| seen wi|
|00005280| 74 68 0d 0a 61 6e 67 69 | 6f 6d 61 74 6f 75 73 20 |th..angi|omatous |
|00005290| 63 75 74 61 6e 65 6f 75 | 73 20 61 6e 64 20 6f 73 |cutaneou|s and os|
|000052a0| 73 65 6f 75 73 20 6c 65 | 73 69 6f 6e 73 20 61 6e |seous le|sions an|
|000052b0| 64 20 73 79 73 74 65 6d | 69 63 20 73 79 6d 70 74 |d system|ic sympt|
|000052c0| 6f 6d 73 2c 20 54 68 65 | 20 63 75 74 61 6e 65 6f |oms, The| cutaneo|
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|000052e0| 61 69 6e 65 64 20 61 20 | 62 61 63 74 65 72 69 75 |ained a |bacteriu|
|000052f0| 6d 20 74 68 61 74 20 61 | 70 70 65 61 72 73 20 69 |m that a|ppears i|
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|00005310| 20 63 61 75 73 69 6e 67 | 20 63 61 74 2d 73 63 72 | causing| cat-scr|
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|00005330| 20 20 20 20 20 54 77 6f | 20 6f 66 20 74 68 65 20 |     Two| of the |
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|00005360| 20 61 20 63 61 74 20 28 | 74 61 62 6c 65 29 2e 20 | a cat (|table). |
|00005370| 20 4d 61 6e 69 66 65 73 | 74 61 74 69 6f 6e 73 0d | Manifes|tations.|
|00005380| 0a 6f 66 20 63 61 74 2d | 73 63 72 61 74 63 68 20 |.of cat-|scratch |
|00005390| 64 69 73 65 61 73 65 20 | 69 6e 63 6c 75 64 65 64 |disease |included|
|000053a0| 20 61 6e 67 69 6f 6d 61 | 74 6f 75 73 20 6e 6f 64 | angioma|tous nod|
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|00005470| 74 72 6f 6e 20 6d 69 63 | 72 6f 73 63 6f 70 69 63 |tron mic|roscopic|
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|000054a0| 73 20 73 68 6f 77 65 64 | 20 65 78 74 72 61 63 65 |s showed| extrace|
|000054b0| 6c 6c 75 6c 61 72 0d 0a | 62 61 63 69 6c 6c 69 20 |llular..|bacilli |
|000054c0| 74 68 61 74 20 73 74 61 | 69 6e 65 64 20 77 69 74 |that sta|ined wit|
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|000054f0| 64 69 73 65 61 73 65 20 | 62 61 63 69 6c 6c 75 73 |disease |bacillus|
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|00005510| 68 20 65 72 79 74 68 72 | 6f 6d 79 63 69 6e 2c 20 |h erythr|omycin, |
|00005520| 64 6f 78 79 63 79 63 6c | 69 6e 65 2c 20 6f 72 20 |doxycycl|ine, or |
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|00005570| 20 61 6e 64 20 62 6f 6e | 65 20 6c 65 73 69 6f 6e | and bon|e lesion|
|00005580| 73 20 61 6e 64 20 6f 66 | 20 73 79 6d 70 74 6f 6d |s and of| symptom|
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|000055b0| 49 74 20 69 73 20 62 65 | 6c 69 65 76 65 64 20 74 |It is be|lieved t|
|000055c0| 68 61 74 20 74 68 65 20 | 63 61 74 2d 73 63 72 61 |hat the |cat-scra|
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|00005690| 68 72 6f 6d 79 63 69 6e | 2c 0d 0a 64 6f 78 79 63 |hromycin|,..doxyc|
|000056a0| 79 63 6c 69 6e 65 2c 20 | 69 73 6f 6e 69 61 7a 69 |ycline, |isoniazi|
|000056b0| 64 2c 20 6f 72 20 72 69 | 66 61 6d 70 69 6e 2e 0d |d, or ri|fampin..|
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|000057a0| 69 27 73 20 73 61 72 63 | 6f 6d 61 2e 20 20 42 75 |i's sarc|oma.  Bu|
|000057b0| 74 20 74 68 69 73 20 69 | 73 20 6e 6f 74 20 61 6c |t this i|s not al|
|000057c0| 77 61 79 73 0d 0a 73 6f | 2c 20 61 73 20 64 65 6d |ways..so|, as dem|
|000057d0| 6f 6e 73 74 72 61 74 65 | 64 20 68 65 72 65 2e 20 |onstrate|d here. |
|000057e0| 20 49 74 20 77 61 73 20 | 66 69 72 73 74 20 72 65 | It was |first re|
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|00005800| 68 61 74 20 61 20 70 61 | 74 69 65 6e 74 20 77 69 |hat a pa|tient wi|
|00005810| 74 68 0d 0a 41 49 44 53 | 20 68 61 64 20 61 6e 67 |th..AIDS| had ang|
|00005820| 69 6f 6d 61 74 6f 75 73 | 20 6e 6f 64 75 6c 65 73 |iomatous| nodules|
|00005830| 20 69 6e 20 77 68 69 63 | 68 20 62 61 63 69 6c 6c | in whic|h bacill|
|00005840| 69 20 77 65 72 65 20 73 | 65 65 6e 2e 20 20 54 68 |i were s|een.  Th|
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|00005870| 66 69 72 73 74 20 64 65 | 73 63 72 69 70 74 69 6f |first de|scriptio|
|00005880| 6e 20 6f 66 20 74 68 65 | 20 6e 61 74 75 72 61 6c |n of the| natural|
|00005890| 20 68 69 73 74 6f 72 79 | 20 6f 66 20 74 68 65 20 | history| of the |
|000058a0| 64 69 73 65 61 73 65 20 | 61 6e 64 0d 0a 65 76 69 |disease |and..evi|
|000058b0| 64 65 6e 63 65 20 74 68 | 61 74 20 74 68 6f 73 65 |dence th|at those|
|000058c0| 20 62 61 63 69 6c 6c 69 | 20 61 72 65 20 69 64 65 | bacilli| are ide|
|000058d0| 6e 74 69 63 61 6c 20 74 | 6f 20 74 68 6f 73 65 20 |ntical t|o those |
|000058e0| 74 68 61 74 20 63 61 75 | 73 65 20 63 61 74 20 73 |that cau|se cat s|
|000058f0| 63 72 61 74 63 68 0d 0a | 64 69 73 65 61 73 65 2e |cratch..|disease.|
|00005900| 20 20 4f 74 68 65 72 20 | 63 6f 6e 66 69 72 6d 61 |  Other |confirma|
|00005910| 74 69 6f 6e 20 74 68 61 | 74 20 74 68 65 73 65 20 |tion tha|t these |
|00005920| 65 70 69 74 68 65 6c 69 | 6f 69 64 20 61 6e 67 69 |epitheli|oid angi|
|00005930| 6f 6d 61 74 6f 75 73 20 | 6c 65 73 69 6f 6e 73 20 |omatous |lesions |
|00005940| 61 72 65 20 6e 6f 74 0d | 0a 6e 65 6f 70 6c 61 73 |are not.|.neoplas|
|00005950| 74 69 63 20 61 6e 64 20 | 61 72 65 20 70 72 6f 62 |tic and |are prob|
|00005960| 61 62 6c 79 20 61 6e 20 | 69 6e 66 6c 61 6d 6d 61 |ably an |inflamma|
|00005970| 74 6f 72 79 20 72 65 73 | 70 6f 6e 73 65 20 74 6f |tory res|ponse to|
|00005980| 20 43 53 44 20 77 61 73 | 20 72 65 70 6f 72 74 65 | CSD was| reporte|
|00005990| 64 0d 0a 69 6e 64 65 70 | 65 6e 64 65 6e 74 6c 79 |d..indep|endently|
|000059a0| 20 66 72 6f 6d 20 57 61 | 73 68 69 6e 67 74 6f 6e | from Wa|shington|
|000059b0| 20 5b 31 5d 2e 0d 0a 20 | 20 20 20 20 49 74 73 20 | [1]... |    Its |
|000059c0| 69 6d 70 6f 72 74 61 6e | 63 65 3f 20 20 54 68 65 |importan|ce?  The|
|000059d0| 73 65 20 6c 65 73 69 6f | 6e 73 20 72 65 73 70 6f |se lesio|ns respo|
|000059e0| 6e 64 20 73 77 69 66 74 | 6c 79 20 74 6f 20 61 70 |nd swift|ly to ap|
|000059f0| 70 72 6f 70 72 69 61 74 | 65 20 61 6e 74 69 6d 69 |propriat|e antimi|
|00005a00| 63 72 6f 62 69 61 6c 0d | 0a 74 68 65 72 61 70 79 |crobial.|.therapy|
|00005a10| 2e 20 20 4b 61 70 6f 73 | 69 27 73 20 73 61 72 63 |.  Kapos|i's sarc|
|00005a20| 6f 6d 61 20 64 6f 65 73 | 20 6e 6f 74 2e 20 20 53 |oma does| not.  S|
|00005a30| 6d 61 6c 6c 20 63 6f 6d | 66 6f 72 74 20 74 6f 20 |mall com|fort to |
|00005a40| 74 68 6f 73 65 20 77 69 | 74 68 20 74 68 69 73 20 |those wi|th this |
|00005a50| 6d 69 73 65 72 61 62 6c | 65 0d 0a 64 69 73 65 61 |miserabl|e..disea|
|00005a60| 73 65 20 28 41 49 44 53 | 29 2c 20 62 75 74 20 69 |se (AIDS|), but i|
|00005a70| 74 20 69 73 20 61 6e 20 | 61 64 76 61 6e 63 65 2e |t is an |advance.|
|00005a80| 2d 2d 44 2e 45 2e 20 52 | 6f 67 65 72 73 2c 20 4d |--D.E. R|ogers, M|
|00005a90| 2e 44 2e 0d 0a 24 55 6e | 69 71 75 65 5f 49 44 7b |.D...$Un|ique_ID{|
|00005aa0| 59 52 42 30 36 36 35 33 | 7d 0d 0a 24 54 69 74 6c |YRB06653|}..$Titl|
|00005ab0| 65 7b 48 69 73 74 6f 70 | 6c 61 73 6d 6f 73 69 73 |e{Histop|lasmosis|
|00005ac0| 20 69 6e 20 50 61 74 69 | 65 6e 74 73 20 61 74 20 | in Pati|ents at |
|00005ad0| 52 69 73 6b 20 66 6f 72 | 20 74 68 65 20 41 63 71 |Risk for| the Acq|
|00005ae0| 75 69 72 65 64 20 49 6d | 6d 75 6e 6f 64 65 66 69 |uired Im|munodefi|
|00005af0| 63 69 65 6e 63 79 20 53 | 79 6e 64 72 6f 6d 65 20 |ciency S|yndrome |
|00005b00| 69 6e 20 61 20 4e 6f 6e | 65 6e 64 65 6d 69 63 20 |in a Non|endemic |
|00005b10| 53 65 74 74 69 6e 67 7d | 0d 0a 24 41 75 74 68 6f |Setting}|..$Autho|
|00005b20| 72 7b 53 61 6c 7a 6d 61 | 6e 2c 20 53 48 0d 0a 53 |r{Salzma|n, SH..S|
|00005b30| 6d 69 74 68 2c 20 52 4c | 0d 0a 41 72 61 6e 64 61 |mith, RL|..Aranda|
|00005b40| 2c 20 43 50 7d 0d 0a 24 | 41 66 66 69 6c 69 61 74 |, CP}..$|Affiliat|
|00005b50| 69 6f 6e 7b 4e 65 77 20 | 59 6f 72 6b 20 56 41 20 |ion{New |York VA |
|00005b60| 4d 65 64 20 43 74 72 3b | 20 4e 65 77 20 59 6f 72 |Med Ctr;| New Yor|
|00005b70| 6b 20 55 6e 69 76 7d 0d | 0a 24 53 75 62 6a 65 63 |k Univ}.|.$Subjec|
|00005b80| 74 7b 48 69 73 74 6f 70 | 6c 61 73 6d 6f 73 69 73 |t{Histop|lasmosis|
|00005b90| 20 69 6e 20 70 61 74 69 | 65 6e 74 73 20 61 74 20 | in pati|ents at |
|00005ba0| 72 69 73 6b 20 66 6f 72 | 20 41 49 44 53 3b 20 41 |risk for| AIDS; A|
|00005bb0| 49 44 53 2c 20 41 63 71 | 75 69 72 65 64 0d 0a 69 |IDS, Acq|uired..i|
|00005bc0| 6d 6d 75 6e 6f 64 65 66 | 69 63 69 65 6e 63 79 20 |mmunodef|iciency |
|00005bd0| 73 79 6e 64 72 6f 6d 65 | 20 68 69 73 74 6f 70 6c |syndrome| histopl|
|00005be0| 61 73 6d 6f 73 69 73 20 | 69 6e 20 70 61 74 69 65 |asmosis |in patie|
|00005bf0| 6e 74 73 20 61 74 20 72 | 69 73 6b 20 66 6f 72 7d |nts at r|isk for}|
|00005c00| 0d 0a 24 4a 6f 75 72 6e | 61 6c 7b 43 68 65 73 74 |..$Journ|al{Chest|
|00005c10| 7d 0d 0a 24 56 6f 6c 75 | 6d 65 7b 39 33 7d 0d 0a |}..$Volu|me{93}..|
|00005c20| 24 50 61 67 65 7b 39 31 | 36 2d 39 32 31 7d 0d 0a |$Page{91|6-921}..|
|00005c30| 24 44 61 74 65 7b 4d 61 | 79 20 31 39 38 38 7d 0d |$Date{Ma|y 1988}.|
|00005c40| 0a 24 59 42 56 6f 6c 7b | 31 39 38 39 20 59 65 61 |.$YBVol{|1989 Yea|
|00005c50| 72 20 42 6f 6f 6b 20 6f | 66 20 4d 65 64 69 63 69 |r Book o|f Medici|
|00005c60| 6e 65 2c 20 50 61 72 74 | 20 4f 6e 65 7d 0d 0a 24 |ne, Part| One}..$|
|00005c70| 43 68 61 70 74 65 72 7b | 31 2d 34 7d 0d 0a 24 59 |Chapter{|1-4}..$Y|
|00005c80| 42 45 64 69 74 6f 72 7b | 44 72 73 2e 20 52 6f 67 |BEditor{|Drs. Rog|
|00005c90| 65 72 73 2c 20 44 65 73 | 20 50 72 65 7a 2c 20 43 |ers, Des| Prez, C|
|00005ca0| 6c 69 6e 65 2c 20 42 72 | 61 75 6e 77 61 6c 64 2c |line, Br|aunwald,|
|00005cb0| 20 47 72 65 65 6e 62 65 | 72 67 65 72 2c 20 57 69 | Greenbe|rger, Wi|
|00005cc0| 6c 73 6f 6e 2c 20 45 70 | 73 74 65 69 6e 2c 20 61 |lson, Ep|stein, a|
|00005cd0| 6e 64 20 4d 61 6c 61 77 | 69 73 74 61 7d 0d 0a 24 |nd Malaw|ista}..$|
|00005ce0| 54 61 62 6c 65 7b 54 61 | 62 6c 65 20 4f 6d 69 74 |Table{Ta|ble Omit|
|00005cf0| 74 65 64 7d 0d 0a 24 43 | 6f 6d 6d 65 6e 74 61 74 |ted}..$C|ommentat|
|00005d00| 6f 72 7b 44 2e 45 2e 20 | 52 6f 67 65 72 73 2c 20 |or{D.E. |Rogers, |
|00005d10| 4d 2e 44 2e 7d 0d 0a 0d | 0a 43 6f 70 79 72 69 67 |M.D.}...|.Copyrig|
|00005d20| 68 74 20 28 63 29 20 59 | 65 61 72 20 42 6f 6f 6b |ht (c) Y|ear Book|
|00005d30| 20 4d 65 64 69 63 61 6c | 20 50 75 62 6c 69 73 68 | Medical| Publish|
|00005d40| 65 72 73 2c 20 49 6e 63 | 2e 2c 20 31 39 38 39 0d |ers, Inc|., 1989.|
|00005d50| 0a 0d 0a 31 39 38 39 20 | 59 65 61 72 20 42 6f 6f |...1989 |Year Boo|
|00005d60| 6b 20 6f 66 20 4d 65 64 | 69 63 69 6e 65 20 28 52 |k of Med|icine (R|
|00005d70| 29 0d 0a 0d 0a 50 61 72 | 74 20 4f 6e 65 3a 20 20 |)....Par|t One:  |
|00005d80| 49 6e 66 65 63 74 69 6f | 75 73 20 44 69 73 65 61 |Infectio|us Disea|
|00005d90| 73 65 73 0d 0a 0d 0a 43 | 68 61 70 74 65 72 20 31 |ses....C|hapter 1|
|00005da0| 2d 2d 41 49 44 53 0d 0a | 0d 0a 2d 2d 2d 2d 2d 2d |--AIDS..|..------|
|00005db0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005dc0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005dd0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005de0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005df0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 0d 0a 48 69 73 74 |--------|--..Hist|
|00005e00| 6f 70 6c 61 73 6d 6f 73 | 69 73 20 69 6e 20 50 61 |oplasmos|is in Pa|
|00005e10| 74 69 65 6e 74 73 20 61 | 74 20 52 69 73 6b 20 66 |tients a|t Risk f|
|00005e20| 6f 72 20 74 68 65 20 41 | 63 71 75 69 72 65 64 20 |or the A|cquired |
|00005e30| 49 6d 6d 75 6e 6f 64 65 | 66 69 63 69 65 6e 63 79 |Immunode|ficiency|
|00005e40| 20 53 79 6e 64 72 6f 6d | 65 20 69 6e 0d 0a 61 20 | Syndrom|e in..a |
|00005e50| 4e 6f 6e 65 6e 64 65 6d | 69 63 20 53 65 74 74 69 |Nonendem|ic Setti|
|00005e60| 6e 67 0d 0a 0d 0a 53 61 | 6c 7a 6d 61 6e 2c 20 53 |ng....Sa|lzman, S|
|00005e70| 48 3b 20 53 6d 69 74 68 | 2c 20 52 4c 3b 20 41 72 |H; Smith|, RL; Ar|
|00005e80| 61 6e 64 61 2c 20 43 50 | 0d 0a 28 4e 65 77 20 59 |anda, CP|..(New Y|
|00005e90| 6f 72 6b 20 56 41 20 4d | 65 64 20 43 74 72 3b 20 |ork VA M|ed Ctr; |
|00005ea0| 4e 65 77 20 59 6f 72 6b | 20 55 6e 69 76 29 0d 0a |New York| Univ)..|
|00005eb0| 43 68 65 73 74 20 39 33 | 3a 39 31 36 2d 39 32 31 |Chest 93|:916-921|
|00005ec0| 4d 61 79 20 31 39 38 38 | 0d 0a 2d 2d 2d 2d 2d 2d |May 1988|..------|
|00005ed0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005ee0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005ef0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005f00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005f10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 0d 0a 0d 0a 50 72 |--------|--....Pr|
|00005f20| 65 2d 63 6f 6d 6d 65 6e | 74 0d 0a 0d 0a 20 20 20 |e-commen|t....   |
|00005f30| 20 20 41 6e 6f 74 68 65 | 72 20 6f 70 70 6f 72 74 |  Anothe|r opport|
|00005f40| 75 6e 69 73 74 69 63 20 | 69 6e 66 65 63 74 69 6f |unistic |infectio|
|00005f50| 6e 20 74 68 61 74 20 69 | 73 20 67 61 69 6e 69 6e |n that i|s gainin|
|00005f60| 67 20 61 70 70 72 65 63 | 69 61 74 69 6f 6e 20 69 |g apprec|iation i|
|00005f70| 73 0d 0a 64 69 73 73 65 | 6d 69 6e 61 74 65 64 20 |s..disse|minated |
|00005f80| 68 69 73 74 6f 70 6c 61 | 73 6d 6f 73 69 73 2e 2d |histopla|smosis.-|
|00005f90| 2d 44 2e 45 2e 20 52 6f | 67 65 72 73 2c 20 4d 2e |-D.E. Ro|gers, M.|
|00005fa0| 44 2e 0d 0a 0d 0a 41 62 | 73 74 72 61 63 74 0d 0a |D.....Ab|stract..|
|00005fb0| 0d 0a 20 20 20 20 20 44 | 69 73 73 65 6d 69 6e 61 |..     D|issemina|
|00005fc0| 74 65 64 20 68 69 73 74 | 6f 70 6c 61 73 6d 6f 73 |ted hist|oplasmos|
|00005fd0| 69 73 20 63 61 6e 20 62 | 65 20 61 64 64 65 64 20 |is can b|e added |
|00005fe0| 74 6f 20 74 68 65 20 61 | 72 72 61 79 20 6f 66 20 |to the a|rray of |
|00005ff0| 69 6e 66 65 63 74 69 6f | 6e 73 20 74 68 61 74 0d |infectio|ns that.|
|00006000| 0a 63 68 61 72 61 63 74 | 65 72 69 7a 65 20 74 68 |.charact|erize th|
|00006010| 65 20 61 63 71 75 69 72 | 65 64 20 69 6d 6d 75 6e |e acquir|ed immun|
|00006020| 6f 64 65 66 69 63 69 65 | 6e 63 79 20 73 79 6e 64 |odeficie|ncy synd|
|00006030| 72 6f 6d 65 20 28 41 49 | 44 53 29 2e 20 20 48 69 |rome (AI|DS).  Hi|
|00006040| 73 74 6f 70 6c 61 73 6d | 6f 73 69 73 0d 0a 6f 63 |stoplasm|osis..oc|
|00006050| 63 75 72 72 65 64 20 69 | 6e 20 31 38 20 70 61 74 |curred i|n 18 pat|
|00006060| 69 65 6e 74 73 20 77 69 | 74 68 20 41 49 44 53 20 |ients wi|th AIDS |
|00006070| 6f 72 20 61 74 20 72 69 | 73 6b 20 66 6f 72 20 41 |or at ri|sk for A|
|00006080| 49 44 53 20 69 6e 20 61 | 20 6e 6f 6e 65 6e 64 65 |IDS in a| nonende|
|00006090| 6d 69 63 20 73 65 74 74 | 69 6e 67 2e 0d 0a 54 68 |mic sett|ing...Th|
|000060a0| 65 20 70 61 74 69 65 6e | 74 73 20 77 65 72 65 20 |e patien|ts were |
|000060b0| 73 65 65 6e 20 61 74 20 | 32 20 4e 65 77 20 59 6f |seen at |2 New Yo|
|000060c0| 72 6b 20 43 69 74 79 20 | 68 6f 73 70 69 74 61 6c |rk City |hospital|
|000060d0| 73 20 77 69 74 68 69 6e | 20 74 68 65 20 70 61 73 |s within| the pas|
|000060e0| 74 20 33 2e 35 20 79 65 | 61 72 73 2e 0d 0a 20 20 |t 3.5 ye|ars...  |
|000060f0| 20 20 20 53 65 76 65 6e | 74 65 65 6e 20 70 61 74 |   Seven|teen pat|
|00006100| 69 65 6e 74 73 20 77 65 | 72 65 20 48 69 73 70 61 |ients we|re Hispa|
|00006110| 6e 69 63 3b 20 31 33 20 | 77 65 72 65 20 62 6f 72 |nic; 13 |were bor|
|00006120| 6e 20 69 6e 20 50 75 65 | 72 74 6f 20 52 69 63 6f |n in Pue|rto Rico|
|00006130| 20 61 6e 64 20 33 20 69 | 6e 0d 0a 53 6f 75 74 68 | and 3 i|n..South|
|00006140| 20 41 6d 65 72 69 63 61 | 3b 20 74 68 65 20 6f 74 | America|; the ot|
|00006150| 68 65 72 20 70 61 74 69 | 65 6e 74 20 77 61 73 20 |her pati|ent was |
|00006160| 62 6f 72 6e 20 69 6e 20 | 74 68 65 20 55 6e 69 74 |born in |the Unit|
|00006170| 65 64 20 53 74 61 74 65 | 73 2e 20 20 54 68 65 20 |ed State|s.  The |
|00006180| 63 6c 69 6e 69 63 61 6c | 0d 0a 70 72 65 73 65 6e |clinical|..presen|
|00006190| 74 61 74 69 6f 6e 20 77 | 61 73 20 73 75 62 61 63 |tation w|as subac|
|000061a0| 75 74 65 20 61 6e 64 20 | 74 79 70 69 63 61 6c 20 |ute and |typical |
|000061b0| 73 79 6d 70 74 6f 6d 73 | 20 69 6e 63 6c 75 64 65 |symptoms| include|
|000061c0| 64 20 68 69 67 68 20 66 | 65 76 65 72 2c 20 77 65 |d high f|ever, we|
|000061d0| 69 67 68 74 20 6c 6f 73 | 73 2c 0d 0a 61 6e 64 20 |ight los|s,..and |
|000061e0| 6d 69 6c 64 20 72 65 73 | 70 69 72 61 74 6f 72 79 |mild res|piratory|
|000061f0| 20 73 79 6d 70 74 6f 6d | 73 20 77 69 74 68 20 77 | symptom|s with w|
|00006200| 65 6c 6c 2d 6d 61 69 6e | 74 61 69 6e 65 64 20 67 |ell-main|tained g|
|00006210| 61 73 20 65 78 63 68 61 | 6e 67 65 2e 20 20 46 69 |as excha|nge.  Fi|
|00006220| 76 65 20 70 61 74 69 65 | 6e 74 73 0d 0a 68 61 64 |ve patie|nts..had|
|00006230| 20 6e 6f 72 6d 61 6c 20 | 66 69 6e 64 69 6e 67 73 | normal |findings|
|00006240| 20 6f 6e 20 63 68 65 73 | 74 20 72 61 64 69 6f 67 | on ches|t radiog|
|00006250| 72 61 70 68 79 2e 20 20 | 54 68 65 20 6d 6f 73 74 |raphy.  |The most|
|00006260| 20 63 6f 6d 6d 6f 6e 20 | 72 61 64 69 6f 67 72 61 | common |radiogra|
|00006270| 70 68 69 63 0d 0a 61 62 | 6e 6f 72 6d 61 6c 69 74 |phic..ab|normalit|
|00006280| 69 65 73 20 77 65 72 65 | 20 64 69 66 66 75 73 65 |ies were| diffuse|
|00006290| 2c 20 73 6d 61 6c 6c 20 | 6e 6f 64 75 6c 65 73 20 |, small |nodules |
|000062a0| 28 46 69 67 20 31 2d 32 | 29 2e 20 20 41 20 72 61 |(Fig 1-2|).  A ra|
|000062b0| 70 69 64 20 64 69 61 67 | 6e 6f 73 69 73 20 77 61 |pid diag|nosis wa|
|000062c0| 73 0d 0a 65 73 74 61 62 | 6c 69 73 68 65 64 20 68 |s..estab|lished h|
|000062d0| 69 73 74 6f 6c 6f 67 69 | 63 61 6c 6c 79 20 69 6e |istologi|cally in|
|000062e0| 20 37 32 25 20 6f 66 20 | 74 68 65 20 70 61 74 69 | 72% of |the pati|
|000062f0| 65 6e 74 73 2c 20 75 73 | 75 61 6c 6c 79 20 62 79 |ents, us|ually by|
|00006300| 20 74 72 61 6e 73 62 72 | 6f 6e 63 68 69 61 6c 0d | transbr|onchial.|
|00006310| 0a 6c 75 6e 67 20 62 69 | 6f 70 73 79 2e 20 20 43 |.lung bi|opsy.  C|
|00006320| 75 6c 74 75 72 65 73 20 | 77 65 72 65 20 70 6f 73 |ultures |were pos|
|00006330| 69 74 69 76 65 20 69 6e | 20 39 34 25 20 6f 66 20 |itive in| 94% of |
|00006340| 74 68 65 20 70 61 74 69 | 65 6e 74 73 2c 20 61 6e |the pati|ents, an|
|00006350| 64 20 73 65 72 6f 6c 6f | 67 79 20 77 61 73 0d 0a |d serolo|gy was..|
|00006360| 70 6f 73 69 74 69 76 65 | 20 69 6e 20 35 20 6f 66 |positive| in 5 of|
|00006370| 20 36 20 70 61 74 69 65 | 6e 74 73 20 28 74 61 62 | 6 patie|nts (tab|
|00006380| 6c 65 29 2e 20 20 4f 6e | 65 20 74 68 69 72 64 20 |le).  On|e third |
|00006390| 6f 66 20 74 68 65 20 70 | 61 74 69 65 6e 74 73 20 |of the p|atients |
|000063a0| 68 61 64 20 69 6e 66 65 | 63 74 69 6f 6e 0d 0a 77 |had infe|ction..w|
|000063b0| 69 74 68 20 4d 79 63 6f | 62 61 63 74 65 72 69 75 |ith Myco|bacteriu|
|000063c0| 6d 20 74 75 62 65 72 63 | 75 6c 6f 73 69 73 20 69 |m tuberc|ulosis i|
|000063d0| 6e 20 61 64 64 69 74 69 | 6f 6e 20 74 6f 20 68 69 |n additi|on to hi|
|000063e0| 73 74 6f 70 6c 61 73 6d | 6f 73 69 73 2e 20 20 4d |stoplasm|osis.  M|
|000063f0| 79 63 6f 62 61 63 74 65 | 72 69 75 6d 0d 0a 74 75 |ycobacte|rium..tu|
+--------+-------------------------+-------------------------+--------+--------+