RADIOLOGY: ABDOMEN: Case# 33064: HISTOPLASMOSIS WITH HSM & NEPHROMEGALY (OLD & NEW SCAN). This is a 32 year old female with high fever and was noted to have increased liver, spleen, and renal size on ultrasound. 1. Diffuse enlargement and homogeneous low attenuation in the liver, spleen, kidneys, and pancreas. THere are no focal lesions identified or lymphadenopathy. These changes may be due to disseminated histoplasmosis. 2. A small amount of ascites, but no loculated fluid collection or abscess identified. 3. Right pleural effusion and bilateral pulmonary consolidation.