A 60 years old male an businessman living in Narnaul district, Haryana, known Hypertensive and Diabetic was admitted in SDMH with complains of severe generalized weakness, diffuse abdominal pain and H/O intermittent low grade fever for 4 months with H/O of weight loss .There was also complain of blackish discolouration of skin over the face, knuckles, elbow, buccal mucosa and chest which had developed over the last month. With differential diagnosis of tuberculosis and malignancy initial workup was done. The initial workup revealed primary adrenal insufficiency and bilateral adrenal space occupying lesion .Further investigation was done and finally on histopathological examination Histoplasmosis was diagnosed and patient was treated with antifungal with clinical recovery.

Our case was rare presentation of isolated adrenal histoplasmosis with adrenal insufficiency in a immunocompetent host in north western region of Rajasthan.

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Dr Sumesh Nirwan

Senior Resident, Dept. of Internal Medicine, SDMH, Jaipur