Histoplasmosis is considered endemic around the gangetic belt in India. In this important paper the authors report a series of twelve patients with Histoplasmosis from the North western parts of India. Though this region is not considered endemic, the presentation of histoplasmosis in this region is similar to the cases seen in the other parts of the country. Adrenal enlargement, palatal ulcers and adenopathy were the common manifestations. Most of the patients were not significantly immunocompromised.
Histoplasmosis should be a differential diagnosis in a patient presenting with adrenal enlargement, lymphadenopathy, oral ulcers and fever of unknown origin in this region. This also underlines the importance of having studies validating the use of Histoplasma antigen (urine and serum) in our population as the clinical syndromes we see are strikingly different from other endemic areas.