Histoplasmosis is a common endemic mycosis that is usually asymptomatic but occasionally results in severe illness. Histoplasmosis and its causative agent, Histoplasma capsulatum, are found worldwide and particularly in North and Central America. Disseminated histoplasmosis is a progressive extrapulmonary infection. The diagnosis of disseminated histoplasmosis should be suspected in patients with risk factors for disease (e. g．，immunosuppression or extremes of age and risk factors for exposure) in combination with clinical manifestations that are consistent with disseminated histoplasmosis. We reported a case of disseminated histoplasmosis in an immunocompetent individual. The case was subacute with rapid progress in the later stage. It was diagnosed by bone marrow smear and metagenomic next-generation sequencing (mNGS). The patient improved after treatment by Amphotericin B deoxycholate and itraconazole. With the increasing reports of disseminated histoplasmosis in China, the clinicians should give careful attention to the disease. The epidemiological status, clinical manifestations, diagnostic criteria and treatment principle of disseminated histoplasmosis were summarized in this paper.