Disseminated histoplasmosis in an elderly man presented with fever,weight loss,abdominal pain and haemoptysis - a case report with literature review

An elderly patient presented with prolonged fever,gross weight loss,recurrent haemoptysis and abdominal pain. he had a background history of adrenal tuberculosis with completion of treatment without any obvious improvement. clinically he was diagnosed as a case of adrenocotical insufficiency. evaluation including histopathology revealed the diagnosis as disseminated histoplasmosis involving adrenal gland and lungs. the disease is a rarity without any underneath immunosuppression and hence high index of suspicion with appropriate steps for investigation is the key to achieve a diagnosis of disseminated histoplasmosis in bangladesh.