Objective: To present the case of a solid organ transplant recipient with Histoplasmosis in New York City.

Case Report: We present a 39-year-old female liver transplant recipient, who experienced a two-week history of progressive shortness of breath and dyspnea on exertion that interfered with all activities of daily living. Physical examination by the team revealed the patient had a WBC of 11.7, + SARS-CoV-2 NP swab, CT Chest with pneumonia, and a urine antigen test positive for Histoplasmosis. Her overall clinical picture was concerning for new Histoplasmosis infection.

Conclusion: Findings endorse the diagnosis of Histoplasmosis. Histoplasmosis is rare in non-endemic regions such as New York City. An infectious workup should include fungal markers to further evaluate shortness of breath and a need to look beyond epidemiologic measures.

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