Abstract: Objective To improve clinicians' awareness and the level of diagnosis and treatment of chronic disseminated histoplasmosis, in order to reduce misdiagnosis and improve the prognosis. Methods To make a literature review about the clinical manifestations, pathological features, diagnosis, treatment of chronic histoplasmosis,according to 2 cases of clinical and follow-up data in our hospital from 1980 to 2012.Results Both two cases of patients have a long course, with the first symptom lack of specific, multi-system involvement, who have no history of specific diseases. One case has gastrointestinal, lung and adrenal gland involvement, and the other one has lung and peritoneal involvement. Both of them are misdiagnosed early,with diagnosis by pathology and good effect by the anti-fungal therapy,neither relapsed. Conclusion Chronic histoplasmosis is rare and the clinical manifestations are not specific, diagnosis depends on the typical pathological morphology and special stains, prognosis is good with aggressive treatment.

Key words: histoplasmosis, oral ulcers, anal fistula, colon polyps, voriconazole