Disseminated Cryptococcosis Causes Adrenal Insufficiency in an Immunocompetent Individual
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概要
- 論文の詳細を見る
Disseminated cryptococcosis infection occurs mainly in the immunocompromised host. There are only a few reports describing disseminated cryptococcosis in immunocompetent patients. Here, we describe the case of a 46-year-old healthy man who presented with primary adrenal insufficiency with hyponatremia, hyperkalemia and skin pigmentation. Contrast-enhanced adrenal computed tomography (CT) revealed bilaterally enlarged adrenal glands without enhancement. CT-guided percutaneous adrenal gland biopsy showed caseous-like necrosis and embedded cryptococcosis. The serum cryptococcal antigen titer was 1 : 512. After ten months of fluconazole treatment, the serum cryptococcal antigen titer remained elevated at 1 : 256 and contrast-enhanced adrenal magnetic resonance imaging revealed continued enlargement of bilateral adrenal glands without enhancement. The patient is currently on a therapeutic regimen of prednisolone, fludrocortisone and fluconazole and is scheduled for regular outpatient follow-up.
- 社団法人 日本内科学会の論文
著者
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Hsu Yung-Hsiang
Division of Pathology, Buddhist Tzu Chi General Hospital
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Lai Yu-Hsien
Division of Nephrology, Buddhist Tzu Chi General Hospital
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Hsu Bang-Gee
Division of Nephrology, Buddhist Tzu Chi General Hospital
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Hung Zui-Sheng
Department of Internal Medicine, Buddhist Tzu Chi General Hospital
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Wang Chih-Hsien
Division of Nephrology, Buddhist Tzu Chi General Hospital
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Fang Te-Chao
Division of Nephrology, Buddhist Tzu Chi General Hospital
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- Disseminated Cryptococcosis Causes Adrenal Insufficiency in an Immunocompetent Individual