Histoplasmosis presenting as addisonian crisis in an immunocompetent host

Abstract

A 71-year-old man with presumptively treated pulmonary tuberculosis ten years earlier andprevious alcoholism presented with adrenal insufficiency. HIV serology was negative. A computerized tomography scan of the abdomen showed enlarged right adrenal. He recovered after emergency treatment with hydrocortisone IV. Right adrenalectomy was performed. Histoplasmosis was diagnosed and the patient was treated with itraconazole, corticosteroid replacement, and discharged with good health.