Retrospective Investigation of Pediatric Histoplasmosis Diagnosed at a Tertiary Children's Hospital in an Endemic Area Over 11 Years.

This article focuses on the clinical presentation, risk factors, diagnostics, and management of pediatric histoplasmosis at a tertiary pediatric care center in an endemic area over nearly 12 years. Among 122 children diagnosed with histoplasmosis, pulmonary/thoracic disease was the most common presentation, followed by disseminated histoplasmosis (DH) and incidental findings. Children with DH more frequently had complex chronic conditions and immunosuppressive medication use, exhibited more severe symptoms such as fever and fatigue, and required longer antifungal treatment courses compared to those with pulmonary/thoracic disease. Diagnostic testing showed higher rates of Histoplasma antigen detection in DH cases, while imaging findings differed between disease categories. Overall, pediatric histoplasmosis presentations and management largely parallel those observed in adults, though challenges remain in disease categorization and exposure documentation.