Q: Out of following organisms which one is prone to produce adrenal insufficiency?

A) Coccidioidomycosis 
B) Histoplasmosis 
C) Aspergillosis 
D) Babesiosis 
E) Legionellosis


Answer: B

Review of literature shows many case reports with disseminated histoplasmosis affecting adrenal glands. Mostly it is reported as unilateral involvement but bilateral involvement has been reported too. Diagnosis is usually made by fine needle aspiration cytology. 


Reference: 

1. Rana C, Krishnani N, Kumari N. - Bilateral adrenal histoplasmosis in immunocompetent patients. - Diagn Cytopathol. 2011 Apr;39(4):294-6. 

2. Kumar M, Singh S, Govil S. Adrenal Histoplasmosis: Clinical presentation and imaging features in 9 cases. Abdominal Imaging, 2003, Sept-Oct.; 28(5); 703 - 708.