Disseminated histoplasmosis in India presenting as addisonian crisis with epiglottis involvement

• Published in: IDCases Vol. 21; p. e00844
• Main Authors: Agrawal, Jatin, Bansal, Naresh, Arora, Anil
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.01.2020; Elsevier
• Subjects: Addisonian crisis; Histoplasmosis; Hypercalcemia; Hypercalcemia; Addisonian crisis; Histoplasmosis
• ISSN: 2214-2509; 2214-2509
• DOI: 10.1016/j.idcr.2020.e00844

•Histoplasmosis is endemic in northeastern part of India.•Addisonian crisis is a rare presentation in disseminated histoplasmosis.•It is also rare cause of hypercalcemia hence in unexplained hypercalcemia Addison’s disease should be ruled out.•Excellent response to antifungal treatment shows the need for timely diagnosis. Histoplasmosis is caused by Histoplasma capsulatum. Like most fungal infections, histoplasmosis is common in immunocompromised patients. In immunocompetent patient, infection is generally asymptomatic and rarely turns into a disseminated form. Addisonian crisis as presentation of disseminated form has been reported in present. Here, we report a case of disseminated histoplasmosis leading to life threatening adrenal crisis and hypercalcemia in an elderly immunocompetent Indian patient. Appropriate diagnosis and anti fungal and steroid treatment lead to dramatic improvement in patient. Histoplasmosis should be considered in a immunocompetent hosts with adrenal involvement.