Rosh Internal Medicine Boost Practice Exam

If a patient is diagnosed with histoplasmosis, where is it likely they recently traveled?

1. Northeastern United States

2. Ohio River Valley

3. Pacific Northwest

4. Southwestern United States

The correct answer is: Ohio River Valley

Histoplasmosis is primarily associated with exposure to soil contaminated with bird or bat droppings, and it is particularly endemic to certain regions of the United States. The Ohio River Valley is a well-known area where Histoplasma capsulatum, the fungus responsible for histoplasmosis, is commonly found. This region includes parts of Ohio, Indiana, and Kentucky, among others. Individuals who have traveled or worked in environments like caves, old buildings, or farmland in this area are at an increased risk of inhaling spores of the fungus. The connection to soil and specific geographic locations makes the Ohio River Valley the most likely place a patient diagnosed with histoplasmosis would have recently traveled to. In contrast, the other regions listed are less commonly associated with the prevalence of this disease, which is why they are less likely to be the correct answer.