Etiology
The
risk
of
infection
is
mostly
related
to
____________________
exposure
and
underlying
immune
status
.
Living
in
endemic
areas
with
contaminated
____________________
increases
the
risk
of
exposure
.
Inoculum
size
plays
a
____________________
.
Individuals
who
are
immunocompetent
and
exposed
to
a
____________________
inoculum
of
histoplasmosis
usually
are
asymptomatic
.
Inhalation
of
a
large
inoculum
can
cause
____________________
pulmonary
symptoms
that
may
have
a
protracted
____________________
.
Immune
status
and
comorbid
factors
affect
causation
.
Reactivation
,
reinfection
,
____________________
complications
of
infection
usually
occur
in
individuals
who
are
immunocompromised
or
____________________
.
Cases
of
histoplasmosis
have
been
reported
in
patients
____________________
infliximab
.
A
high
index
of
suspicion
should
be
present
in
patients
on
tumor
necrosis
factor
-
alpha
inhibitors
.
____________________
therapy
in
these
patients
is
highly
effective
;
however
,
the
____________________
of
restarting
tumor
necrosis
factor
inhibitors
remains
unclear
.
Histoplasmosis
is
rare
in
solid
organ
transplant
patients
;
most
____________________
have
been
reported
from
the
midwest
,
where
it
is
endemic
.
Chronic
____________________
histoplasmosis
is
more
prevalent
in
patients
with
underlying
emphysema
.
The
risk
factors
include
AIDS
,
primary
immunodeficiencies
,
drug
-
induced
immunosuppressive
states
,
and
the
extremes
of
age
.