Disseminated histoplasmosis mimicking miliary tuberculosis: a case ...

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The ~ntermediate duration of illness,
preserice of' weighk loss, hepatosplenornegaly
and focal destructive lesions, especially in the
adrenal glands, place our patienl into the subacute
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il is invariably thc first differential diagnosis in
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Steroids should not be giver] in any
granulomatous disease unless histoplasmosis had
been exclrided, as it has been reported Lhal this
frequently results in a fatal o~tcorne.~"
'l'his patient had very severe adrenal gland
involve~nent. Antemortern findings suggestive
of adrcnal insufficiency include a marginally
IOW blood pressurc and serum sodiuln level.
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