A variety of well-known conditions can predispose to disseminated histoplasmosis, that is, AIDS, immunosuppressive medications such as glucocorticoids, antirejection therapies in solid organ transplantation or TNF alpha inhibitors therapies, primary immunodeficiency, and extremes of age [9–11]. Histoplasma capsulatum is a well-recognized but uncommon cause of granulomatous hepatitis. The gene discussed is TNF; the disease is inborn error of immunity.