Adrenal hypofunction from histoplasmosis: A literature review from 1971 to 2012

Purpose: While histoplasmosis has been reported from most continents, the disease is most often recognized in the midwestern United States. The recent diagnosis of adrenal hypofunction in two patients with progressive disseminated histoplasmosis (PDH) in our hospital led us to review the literature. Methods: We reviewed PubMed using the search term "adrenal histoplasmosis" for the years 1971 to 2012. Results: The results included 242 patients with adrenal histoplasmosis from either case reports or case series. Most of the reported patients were from countries not previously considered to be heavily endemic for histoplasmosis. In addition, 41.3 % of patients with adrenal involvement developed adrenal hypofunction. Conclusion: As modern technology elucidates more cases of adrenal histoplasmosis, the global boundaries of endemicity are being redefined.