1.IntroductionHistoplasma capsulatum infection is uncommon in pregnancy and rarely crosses the placenta. Pregnancy may limit safety in diagnostic imaging and antifungal treatment options. It is recognized that tumor necrosis factor–α (TNF-α) inhibitors heighten susceptibility to invasive fungal disease, Maternal–fetal transmission is rare and has been reported only sporadically. We describe a pregnant patient with recent infliximab exposure who developed disseminated histoplasmosis - that was transmitted to her infant - and highlights the need for early recognition and coordinated maternal–fetal management.