Histoplasma capsulatum in the bone marrow of an HIV-infected patient.

•Histoplasmosis is one of the differential diagnoses for pancytopenia in HIV-infected patients.•Histoplasma capsulatum yeasts can be identified on analysis of bone marrow aspirate.•Urinary antigen testing has a high sensitivity in immunocompromised patients.•Amphotericin B is the primary therapy for severe disseminated histoplasmosis.•Long-term suppressive therapy with oral itraconazole may be required.