{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:11:07Z","timestamp":1791591067990,"version":"4.3.4"},"reference-count":20,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,4,10]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>Disseminated histoplasmosis, with the adrenal glands as being the only site of demonstrable disease in an immunocompetent adult, is a rare infection leading to adrenal insufficiency. This disease carries high mortality when unrecognised. We describe the first reported case of adrenal histoplasmosis in the Philippines in a 72-year-old immunocompetent, Filipino man who presented with a 3-month history of intermittent flank pain, weight loss and generalised weakness. His imaging demonstrated bilateral adrenal masses on ultrasonography and contrast-enhanced CT scan. The initial impression was adrenal cancer, however, fine-needle aspiration cytology revealed the presence of yeast cells and blood culture grew <jats:italic>Histoplasma capsulatum<\/jats:italic>. The diagnosis of the case represents a diagnostic challenge in immunocompetent individuals because they manifest with non-specific symptoms. A heightened suspicion is therefore needed to prevent significant morbidity and mortality.<\/jats:p>","DOI":"10.1136\/bcr-2020-234935","type":"journal-article","created":{"date-parts":[[2020,5,13]],"date-time":"2020-05-13T05:45:15Z","timestamp":1589348715000},"page":"e234935","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Bilateral adrenal histoplasmosis presenting as adrenal insufficiency in an immunocompetent host in the Philippines"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2864-2879","authenticated-orcid":false,"given":"Ma Carrissa Abigail","family":"Roxas","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, College of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0622-8287","authenticated-orcid":false,"given":"Mark Anthony Santiago","family":"Sandoval","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, College of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Sonia","family":"Salamat","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Disease, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick Joseph","family":"Matias","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Philippine General Hospital, University of the Philippines Manila, Manila, 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