Isolated Bilateral Adrenal Histoplasmosis With Addisonian Crisis in an Immunocompetent Host

Abstract

Bilateral adrenal histoplasmosis presenting as an adrenal crisis and being the only site of demonstrable disease in an immunocompetent adult is a rare presentation. The adrenal gland is frequently involved in disseminated histoplasmosis but commonly presents as unilateral mass; isolated bilateral involvement in an immunocompetent patient is rare. We describe a patient case of 38-year-old man presenting with epigastric pain, intermittent low-grade fever, nausea and vomiting, skin darkening, generalized weakness, and weight loss for 6 months. Investigations suggested primary adrenal insufficiency. On imaging, patient was found to have bilateral adrenal masses. The histopathological examination revealed Histoplasma species.