报告一例北京居民发病的肺组织胞浆菌病，初始诊断肺结核，抗结核治疗病变恶化。胸部ＣＴ示两肺散在大小不一斑片状密度增高影，密度不均，部分有空洞影，两肺门影增大，经胸壁肺活检病理报告找到英膜组织胞浆菌，病人住院期间尚出现皮疹──癣菌疹，经氟康唑治疗肺部病变大部吸收，皮疹消退。并结合文献复习进行了讨论。 A case of Beijing residents reported pulmonary histoplasmosis, the initial diagnosis of tuberculosis, anti-TB treatment of the disease worsened. Chest CT showed two lungs were scattered in the size of patchy density increased shadow, uneven density, some empty shadow, two hilar shadow increased by chest wall biopsy pathology report to find the British film histoplasmosis, the patient still appears during hospitalization Rash ─ ─ ringworm rash, most of the pulmonary disease by fluconazole absorption, the rash subsided. And discussed with the literature review.