This patient presents a diffuse swelling of the lower lip with an extensive tumor-like ulceration. This is a secondary infection after haematogenous dissemination. The primary infection took place after the inhalation of the fungus Histoplasma capsulatum var. capsulatum, the classical small variety of the genus Histoplasma capsulatum a so called dimorphic fungus with formation of foci in the lungs, often as a primary complex.