Histoplasmosis is an important systemic fungal infection in endemic areas. It has been reported from various states of India, with particular endemicity in north-eastern regions. Most infections are asymptomatic or self-limited, some individuals develop acute pulmonary infections or severe and progressive disseminated infection. Primary infection occurs in lungs and can also involve skin, lymph nodes, GIT, CNS, adrenals, liver and spleen. The particular interest of this paper is to present a case of disseminated histoplasmosis in diabetic patient and to demonstrate the importance of direct KOH mount preparation for diagnosis of such cases.