Reversal of Adrenal Glucocorticoid Dysfunction in a Patient with Disseminated Histoplasmosis
Authors: Ronald G. Washburn
Journal: Annals of Internal Medicine (1989)

Brief Reports1 January 1989Reversal of Adrenal Glucocorticoid Dysfunction in a Patient with Disseminated HistoplasmosisRonald G. Washburn, MD, John E. Bennett, MDRonald G. Washburn, MD, John E. Bennett, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-1-86 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDisseminated histoplasmosis frequently affects the adrenal cortex (1, 2); involvement may range from asymptomatic inflammation of cortical sinusoids with parasitized macrophages (1, 3) to extensive necrosis resulting in potentially fatal Addison disease (1, 2, 4-8). In most reported cases with clinically apparent adrenocortical dysfunction, the assumption was made that tissue destruction was complete and permanent, necessitating lifelong steroid replacement. We report a case of disseminated histoplasmosis in which severely compromised adrenal glucocorticoid function returned to normal after a prolonged course of antifungal chemotherapy with ketoconazole.A previously healthy 63-year-old black woman noted pruritus over the left vulvar area in January...References1. GoodwinShapiroThurmanThurmanDes Prez RJGSR. Disseminated histoplasmosis: clinical and pathologic corrrelations. Medicine (Baltimore). 1980;59:1-33. CrossrefMedlineGoogle Scholar2. SarosiVothDahlDotoTosh GDBIF. Disseminated histoplasmosis: results of long-term follow-up. Ann Intern Med. 1971;75:511-6. LinkGoogle Scholar3. SmithUtz JJ. Progressive disseminated histoplasmosis. A prospective study of 26 patients. Ann Intern Med. 1972;76:557-65. LinkGoogle Scholar4. Bennett D. Histoplasmosis of the oral cavity and larynx. A clinicopathologic study. Arch Intern Med. 1967;120:417-27. CrossrefMedlineGoogle Scholar5. MacleodMurrayDavidsonGibbs WIJD. Histoplasmosis. A review, and account of three patients diagnosed in Great Britain. Thorax. 1972;27:6-17. CrossrefMedlineGoogle Scholar6. MurphyRao KA. Adrenal failure and relapse following treatment of systemic histoplasmosis. Med J Aust. 1970;2:27-8. CrossrefMedlineGoogle Scholar7. RooyenCusins RvP. Addison's disease due to Histoplasma capsulatum. S A fr Med J. 1973;47:1953-5. MedlineGoogle Scholar8. VanekSchwarz JJ. The gamut of histoplasmosis. Am J Med. 1971;50:89-104. CrossrefMedlineGoogle Scholar9. PayaHermansVan ScoyRittsHomburger CPRRH. Repeatedly relapsing disseminated histoplasmosis: clinical observations during long-term follow-up. J Infect Dis. 1987;156:308-12. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the National Institute of Allergy and Infectious Diseases, Bethesda, Maryland. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAdrenal function and dysfunction in critically ill patientsClinical outcomes and cortical reserve in adrenal histoplasmosis-A retrospective follow-up study of 40 patientsBilateral adrenal histoplasmosis in immunocompetent patientsEndocrine and Metabolic Manifestations of Invasive Fungal Infections and Systemic Antifungal TreatmentBilateral adrenal histoplasmosis in an immunocompetent manCHRONIC DISSEMINATED HISTOPLASMOSIS IN AN APPARENTLY IMMUNO-COMPETENT BELGIAN PATIENTPrimary Adrenal Insufficiency Caused by Disseminated Histoplasmosis: Report of Two CasesA Combined Model for Supervisory Control of Continuous ProcessesAdrenal bilateral incidentaloma by reactivated histoplasmosisTuberculous Addison's disease: lack of normalization of adrenocortical function after anti-tuberculous chemotherapyHistoplasmosis: Experience During Outbreaks in Indianapolis and Review of the LiteratureHypoadrenal crisis caused by disseminated histoplasmosisAcute Adrenal InsufficiencyBacterial and Fungal Infections 1 January 1989Volume 110, Issue 1Page: 86-87KeywordsAdrenal cortexAllergy and immunologyAntifungalsChemotherapyHistoplasmosisInfectious diseasesInflammationMetastasisNecrosisPruritus Issue Published: 1 January 1989 PDF DownloadLoading ...