Which finding indicates progression of histoplasmosis in a client with AIDS?

Enlargement of the lymph nodes in a client with AIDS can indicate the progression of histoplasmosis, a fungal infection that often affects individuals with weakened immune systems, such as those with HIV/AIDS. In this context, lymphadenopathy is associated with the body's immune response to the histoplasma fungus. As the infection advances, the immune system struggles to contain it, leading to the involvement of lymph nodes.

Histoplasmosis in immunocompromised patients can lead to disseminated disease, and the presence of enlarged lymph nodes suggests that the infection is spreading beyond the lungs, which is common in severe cases. In contrast to the other choices, which may not specifically correlate with disease progression or might indicate a less severe or different clinical picture, lymph node enlargement is a specific sign that the infection is worsening and requiring urgent medical attention.