Infectious conidia of H. capsulatum are inhaled with dust from contaminated soils and develop into the yeast form. The organisms promptly enter macrophages and grow intracellularly. Granulomas develop in infected areas, closely resembling those seen in tuberculosis, sometimes even showing caseation necrosis. Eventually, the lesions are replaced with scar tissue, and many calcify, meaning that the body deposits calcium compounds in them that show up on X rays. In rare cases, the disease is not controlled and spreads throughout the body. This suggests AIDS or other immunodeficiency.

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