We describe a rare case of multiple skeletal lesions and a pleural effusion owing to Histoplasma capsulatum infection in a 16-year-old immunocompetent girl residing in a non-endemic region. Of note is that the patient had a lesion within a thoracic vertebra. Following an extensive literature search, we found that vertebral involvement by H. capsulatum had not been previously described. Pleural effusion and skeletal lesions are both rare manifestations of H. capsulatum infection.
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