Addison’s disease due to disseminated histoplasmosis: A case report

Authors

  • Krittaya Rattanakorn King Chulalongkorn Memorial Hospital, The Thai Red Cross Society
  • Ratchathorn Panchaprateep King Chulalongkorn Memorial Hospital, The Thai Red Cross Society

Keywords:

Addison’s disease, disseminated histoplasmosis

Abstract

Addison’s disease, also known as primary adrenal insufficiency, can manifest as generalized mucocutaneous hyperpigmentation. The common causes of Addison’s disease in developing countries are mycobacterium and fungal infections. Histoplasma capsulatum is a dimorphic fungi, which may disseminate to the adrenal glands and skin, causing Addison’s disease and skin lesions such as macules, acneiform pustular eruptions, erythematous papules, nodules, keratotic plaques with or without crust and mucosal ulceration.

We present a case of a 45-year-old male with Addisonian pigmentation for one year together with multiple skin-colored flat top papules on both inguinal areas 3 months earlier. Cutaneous lesions were carefully physical examined might easily lead to the cause of Addison’s disease by using biopsy from skin lesions which found histoplasma capsulatum same as found in fine needle aspiration (FNA) from right adrenal mass.

Downloads

Download data is not yet available.

References

Sarkar SB, Sarkar S, Ghosh S, Bandyopadhyay S. Addison's disease. Contemp Clin Dent 2012; 3:484-6.

https://doi.org/10.4103/0976-237X.107450

Chakera AJ, Vaidya B. Addison disease in adults: diagnosis and management. Am J Med 2010; 123:409-13. https://doi.org/10.1016/j.amjmed.2009.12.017

Bornstein SR, Allolio B, Arlt W, Barthel A, DonWauchope A, Hammer GD, et al. Diagnosis and treatment of primary adrenal insufficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2016;101: 364-89. https://doi.org/10.1210/jc.2015-1710

Ten S, New M, Maclaren N. Addison's Disease 2001. J Clin Endocrinol Metab 2001; 86: 2909-22.

https://doi.org/10.1210/jcem.86.7.7636

Yasaratne BMGD, Madegedara DM. Tuberculosis of the skin. J Cey Coll Phy 2010;41:83-8.

https://doi.org/10.4038/jccp.v41i2.3771

Gta J, Akaa PD, Banwat EB. A review of literature on unusual clinical presentations and potential challenges in diagnosis of histoplasmosis. J Clin Med Res 2010; 2:159-66.

Kandi V, Vaish R, Palange P. Bhoomagiri MR. Chronic pulmonary histoplasmosis and its clinical significance: an under-reported systemic fungal disease. Cureus 2016;8: e751

https://doi.org/10.7759/cureus.c6

Rozenblit AM, Kim A, Tuvia J, Wenig BM. Adrenal histoplasmosis manifested as addison's disease: unusual CT features with magnetic resonance imaging correlation. Clin Radiol 2001; 56:682-4.

https://doi.org/10.1053/crad.2000.0713

Kauffman CA. Histoplasmosis: a clinical and laboratory update. Clin Microbiol Rev 2007; 20:115-32.

https://doi.org/10.1128/CMR.00027-06

Falci DR, Hoffmann ER, Paskulin RR, Pasqualotto AC. Progressive disseminated histoplasmosis: a systematic review on the performance of non-culture-based diagnostic tests. Braz J Infect Dis 2017;21:7-11. https://doi.org/10.1016/j.bjid.2016.09.012

Honarpisheh HH, Curry JL, Richards K, Nagarajan P, Aung PP, Torres-Cabala CA, et al. Cutaneous histoplasmosis with prominent parasitization of epidermal keratinocytes: report of a case. J Cutan Pathol 2016; 43: 1155 -60. https://doi.org/10.1111/cup.12792

Downloads

Published

2023-08-24

How to Cite

1.
Rattanakorn K, Panchaprateep R. Addison’s disease due to disseminated histoplasmosis: A case report. Chula Med J [Internet]. 2023 Aug. 24 [cited 2024 Nov. 22];61(4). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/467