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A 64-year-old man, born in France, who had lived in Algeria, was admitted to the hospital in May, 2001, with a 12 kg weight loss, bleeding in his mouth, and a 3-month history of toe ulcerations. He was a heavy smoker and drinker, who had undergone a bilateral aorto-femoral by-pass in 2000. In March, 2000, he was admitted to hospital for gum and palate ulcerations and hepatitis. A biopsy specimen of his gum showed non-specific inflammation. Although he had visited no endemic regions, a serological test for Histoplasma capsulatum was done and was positive. Treatment with itraconazole, 200 mg twice daily, and amphotericin B (total dose of 800 mg over 2 months) was started. H capsulatum var capsulatum is rare in France and in Algeria: most infected people have a history of visiting regions of high endemicity (West and Central Africa, the USA, and Central America). Chronic histoplasmosis is due to reactivation of a latent infection and usually affects patients with prediposing factors such as tuberculosis and immunodeficiency.