Would you recommend antifungal treatment or observation without therapy in an immunocompetent patient with a pulmonary nodule who underwent malignancy workup and was found to have yeast forms consistent with histoplasma on GMS stain? 

Would you recommend antifungal treatment or observation without therapy in an immunocompetent patient with a pulmonary nodule who underwent malignancy workup and was found to have yeast forms consistent with histoplasma on GMS stain?

• I would recommend antifungal treatment regardless of immunosuppression status
• I would recommend observation without antifungal treatment if the patient has no immunosuppression and a negative urine histoplasma antigen
• I would recommend antifungal treatment only if the urine histoplasma antigen is positive, regardless of immunosuppression status
• I would recommend antifungal treatment only if previously undiagnosed immunosuppression is discovered (e.g., HIV+), regardless of urine histoplasma antigen
• Other