Histoplasmosis is a fungal infection that may be opportunistic in the context of HIV. Rare in Europe, it is always imported. The two variants of histoplasmosis are encountered in defined geographic areas: var. capsulatum in Americas, Africa and Asia; and var duboisii in Africa only. In immuno-competent patients, acute infection is often asymptomatic, or it may cause a pulmonary syndrome of variable severity. Among immuno-compromised patients, histoplasmosis is disseminated and life-threatening. Diagnosis is typically made by cultures. The treatment of the disseminated form must be started immediately with anti-fungal therapy and highly active anti-retroviral treatment. In a globalized world, one has to remember the importation of unusual exotic diseases.