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Usually, histoplasmosis is clinically suspected only in people who reside in or travel to endemic areas. This report widens the epidemiologic spectrum of Histoplasma capsulatum infection by demonstrating its spread to 2 renal-transplant recipients in nonendemic regions from cadaveric kidneys harvested from a donor who lived in a highly endemic area. One transplant recipient resided in Montana and received his transplant in Seattle; the other lived and received his transplant in Oregon. Neither had ever traveled to histoplasmosis-endemic areas or had contact with each other. Each received a kidney from a previously healthy Kansas trauma victim.
The transplant recipients developed fever, weight loss, and pancytopenia at 8 and 9 months, respect…