Dimorphic fungus. Environmental form: hyphae with microconidia. Tissue form: intracellular yeasts, no capsule.

Location: Mississippi and Ohio River Valleys- Found in soil with bird (eg, starlings) or bat droppings

Pathology: Macrophages filled with dimorphic fungus with septate hyphae.

Symptoms:- Palatal/tongue ulcers- Splenomegaly- Lesions have a tendency to calcify after they heal.

Diagnosis: Positive urine and serum polysaccharide antigen test.

Treatment: Itraconazole for mild, amphotericin B for severe