组织胞浆菌病,由吸入荚膜组织分生孢子孢子引起的真菌感染,已被证明在免疫功能低下的个体中引起播散性疾病。播散性组织胞浆菌病表现为多系统受累,包括肺和/或神经系统疾病。影像学发现,如肺局灶性浸润,空洞性结节,纵隔,肺门淋巴结肿大,很常见。这里,我们报告了一例罕见的播散性组织胞浆菌病病例,该病例为一名58岁无职业暴露的免疫功能正常的男性.这个病人表现为原发性肾上腺功能不全,随后进行了CT引导下的肾上腺活检,发现许多孢子中含有组织胞浆。该患者还患有许多肺部和神经系统紊乱,这可能是播散性真菌感染的后遗症。最终,病人死于疾病,死了。防止这种结果依赖于早期发现和及时管理,这对治疗播散性组织胞浆菌病至关重要。提高对非典型表现的认识可以提高患者的预后并减轻这种严重真菌感染的影响。这种情况不仅强调了在表现出无法解释的体重减轻和肾上腺功能不全的免疫功能正常的患者中考虑播散性组织胞浆病的重要性,而且还为有关免疫功能正常个体中播散性组织胞浆病的有限文献做出了贡献。
Histoplasmosis, a fungal infection caused by the inhalation of Histoplasma capsulatum conidia spores, has been shown to cause disseminated disease in immunocompromised individuals. Disseminated histoplasmosis manifests as multi-system involvement including pulmonary and/or neurological disease. Imaging findings, such as pulmonary focal infiltrates, cavitary nodules, mediastinal, and hilar lymphadenopathy, are common. Here, we report a rare case of disseminated histoplasmosis in a 58-year-old immunocompetent male with no occupational exposure. This patient presented with primary adrenal insufficiency, and a subsequent CT-guided biopsy of the adrenal gland was performed and revealed numerous spores containing Histoplasma capsulatum. This patient also suffered from numerous pulmonary and neurological derangements, which are likely sequelae of the disseminated fungal infection. Ultimately, the patient succumbed to their illness and died. Preventing such outcomes relies on early detection and prompt management, which are crucial in treating disseminated histoplasmosis. Increased awareness of atypical presentations can enhance patient outcomes and alleviate the impact of this severe fungal infection. This case not only underscores the importance of considering disseminated histoplasmosis in an immunocompetent patient presenting with unexplained weight loss and adrenal insufficiency but also contributes to the limited literature on disseminated histoplasmosis in immunocompetent individuals.