Disseminated cryptococcosis causes adrenal insufficiency in an immunocompetent individual

Zui Sheng Hung, Yu Hsien Lai, Yung Hsiang Hsu, Chih Hsien Wang, Te Chao Fang, Bang Gee Hsu

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1023-1026
Number of pages4
JournalInternal Medicine
Volume49
Issue number11
DOIs
Publication statusPublished - 2010
Externally publishedYes

Fingerprint

Cryptococcosis
Adrenal Insufficiency
Adrenal Glands
Fluconazole
Fludrocortisone
Tomography
Skin Pigmentation
Antigens
Addison Disease
Hyperkalemia
Hyponatremia
Immunocompromised Host
Prednisolone
Serum
Necrosis
Outpatients
Magnetic Resonance Imaging
Biopsy
Therapeutics
Infection

Keywords

  • Adrenal insufficiency
  • Disseminated cryptococcosis
  • Immunocompetent patient

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Disseminated cryptococcosis causes adrenal insufficiency in an immunocompetent individual. / Hung, Zui Sheng; Lai, Yu Hsien; Hsu, Yung Hsiang; Wang, Chih Hsien; Fang, Te Chao; Hsu, Bang Gee.

In: Internal Medicine, Vol. 49, No. 11, 2010, p. 1023-1026.

Research output: Contribution to journalArticle

Hung, Zui Sheng ; Lai, Yu Hsien ; Hsu, Yung Hsiang ; Wang, Chih Hsien ; Fang, Te Chao ; Hsu, Bang Gee. / Disseminated cryptococcosis causes adrenal insufficiency in an immunocompetent individual. In: Internal Medicine. 2010 ; Vol. 49, No. 11. pp. 1023-1026.
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