Acute pulmonary infection can present as abrupt-onset fever, chills, pleuritic chest pain, myalgias, and arthralgias. However, most pts with pulmonary blastomycosis have chronic indolent pneumonia with fever, weight loss, productive cough, and hemoptysis. Skin disease is common and can present as verrucous (more common) or ulcerative lesions. Blastomycosis can include osteomyelitis in one-fourth of infections and CNS disease in ~40% of pts with AIDS.