ADA and histoplasmosis: High ADA levels in lymphocytic pleural effusions have also been reported in rheumatoid arthritis, lymphoma, bronchoalveolar carcinoma, mesothelioma, systemic lupus erythematosus, mycoplasma and chlamydia pneumonia, psittacosis, paragonimiasis, infectious mononucleosis, brucellosis, familial Mediterranean fever, histoplasmosis and coccidioidomycosis [22].