Emily, a 43-year-old HIV-positive woman, presented with fever, chronic cough, chest pain, and rashes on her shins. Her medical history included exploring caves and renovating an abandoned poultry farm. Tests found erythema nodosum, hilar lymphadenopathy on chest x-ray, yeast-like structures in neutrophils on biopsy, and a positive antigen test for Histoplasma capsulatum. The most likely diagnosis is histoplasmosis, which is caused by the dimorphic fungus Histoplasma capsulatum commonly found in caves and areas with birds or bats.