Adrenal histoplasmosis with disseminated cutaneous manifestations in an immunocompetent patient: A case report

Abstract

This report describes a case of adrenal histoplasmosis along with disseminated cutaneous involvement in a 48-year-old immunocompetent male. The patient presented with multiple erythematous nodules on the skin of the scalp, face, back, thigh, abdomen, and soles. Abdominal computed tomography (CT) imaging revealed bilateral adrenomegaly, with hepatosplenomegaly. Histological examination of the biopsy specimen from both the skin lesion and CT-guided fine-needle aspiration cytology (FNAC) aspirates of the adrenal gland showed a granulomatous infiltrate with numerous intracellular Periodic Acid Schiff (PAS)-positive rounded yeast cells within the macrophages. Culturing of these materials, incubated in Sabouraud′s agar, showed growth of Histoplasma capsulatum. Treatment with itraconazole showed an excellent response.

Keywords

• Adrenal
• erythematous nodules
• histoplasmosis
• itraconazole