Adrenal Involvement in Disseminated Histoplasmosis

An 82 year old man presented with 3 years of progressive weakness and an 8 kg weight loss. Imaging revealed bilateral adrenal masses with fluorodeoxyglucose uptake and splenomegaly. Biopsy of the left adrenal mass showed necrotizing granulomatous inflammation with intracellular fungal organisms identified as Histoplasma capsulatum via Grocott's mAn 82-year-old man presented with 3 years of progressive weakness and an 8 kg weight loss. Imaging revealed bilateral adrenal masses with fluorodeoxyglucose uptake and splenomegaly. Biopsy of the left adrenal mass showed necrotizing granulomatous inflammation with intracellular fungal organisms identified as Histoplasma capsulatum via Grocott's methenamine silver staining, confirming chronic progressive disseminated histoplasmosis. Despite initiating itraconazole therapy, the patient died from hospital acquired pneumonia on day 13. This case highlights adrenal involvement as a rare manifestation of disseminated histoplasmosis, particularly in immunocompromised hosts.ethenamine silver staining, confirming chronic progressive disseminated histoplasmosis. Despite initiating itraconazole therapy, the patient died from hospital acquired pneumonia on day 13. This case highlights adrenal involvement as a rare manifestation of disseminated histoplasmosis, particularly in immunocompromised hosts.

An 82 year old man presented with 3 years of progressive weakness and an 8 kg weight loss. Imaging revealed bilateral adrenal masses with fluorodeoxyglucose uptake and splenomegaly. Biopsy of the left adrenal mass showed necrotizing granulomatous inflammation with intracellular fungal organisms identified as Histoplasma capsulatum via Grocott's mAn 82-year-old man presented with 3 years of progressive weakness and an 8 kg weight loss. Imaging revealed bilateral adrenal masses with fluorodeoxyglucose uptake and splenomegaly. Biopsy of the left adrenal mass showed necrotizing granulomatous inflammation with intracellular fungal organisms identified as Histoplasma capsulatum via Grocott's methenamine silver staining, confirming chronic progressive disseminated histoplasmosis. Despite initiating itraconazole therapy, the patient died from hospital acquired pneumonia on day 13. This case highlights adrenal involvement as a rare manifestation of disseminated histoplasmosis, particularly in immunocompromised hosts.ethenamine silver staining, confirming chronic progressive disseminated histoplasmosis. Despite initiating itraconazole therapy, the patient died from hospital acquired pneumonia on day 13. This case highlights adrenal involvement as a rare manifestation of disseminated histoplasmosis, particularly in immunocompromised hosts.