Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Disseminated Cryptococcosis Causes Adrenal Insufficiency in an Immunocompetent Individual
Zui-Sheng HungYu-Hsien LaiYung-Hsiang HsuChih-Hsien WangTe-Chao FangBang-Gee Hsu
Author information
JOURNAL OPEN ACCESS

2010 Volume 49 Issue 11 Pages 1023-1026

Details
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.

Content from these authors
© 2010 by The Japanese Society of Internal Medicine
Previous article Next article
feedback
Top