Disseminated histoplasmosis can present with hoarseness, fever, weight loss and multi-organ involvement. Adrenal enlargement is common but may not always cause insufficiency. Histopathology and fungal stains (PAS, GMS, and LPCB) are diagnostic gold standards. High clinical suspicion is needed in endemic regions or immunocompromised hosts.
Singhal et al. (Wed,) studied this question.