Adrenocortical insufficiency caused by Cryptococcus neoformans: a case report and literature review

Objective To explore the clinical features, diagnosis and treatment regimen of adrenal cryptococcosis so as to improve awareness of this disease for clinicians. Methods The clinical manifestations, laboratory indicators, imaging data and postoperative pathological results of a patient with adrenocor...

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Main Authors: LIU Hongwei, LI Shihao, ZHU Yi, GUI Zhiming, XU Zhijian
Format: Article
Language:zho
Published: Editorial Office of Journal of Army Medical University 2023-05-01
Series:陆军军医大学学报
Subjects:
Online Access:http://aammt.tmmu.edu.cn/html/202211158.htm
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author LIU Hongwei
LI Shihao
ZHU Yi
GUI Zhiming
XU Zhijian
author_facet LIU Hongwei
LI Shihao
ZHU Yi
GUI Zhiming
XU Zhijian
author_sort LIU Hongwei
collection DOAJ
description Objective To explore the clinical features, diagnosis and treatment regimen of adrenal cryptococcosis so as to improve awareness of this disease for clinicians. Methods The clinical manifestations, laboratory indicators, imaging data and postoperative pathological results of a patient with adrenocortical insufficiency caused by Cryptococcus neoformans infection admitted to our hospital in June 2022 were collected and analyzed, and the related literature was reviewed. Results This patient presented with dizziness, fatigue, and multiple pigmentations throughout the whole body.Upper abdominal plain CT scan on June 24, suggested multiple nodular soft tissue shadows in the bilateral adrenal glands, and the scan on July 1 suggested mild inhomogeneous enhancement of bilateral adrenal nodules, which may be adrenal tumors.Retroperitoneal laparoscopic partial adrenalectomy was performed on July 13.Postoperative pathology indicated cryptococcosis.The antifungal treatment with itraconazole was stopped after 2 weeks by himself.In 3 months after the operation, CT revealed multiple adrenal masses on both sides, and itraconazole was taken again for treatment. Conclusion Patients with adrenal cryptococcosis usually have symptoms of adrenocortical insufficiency such as dizziness, fatigue, and multiple pigmentations throughout the whole body.Abdominal enhanced CT usually indicates adrenal nodules with inhomogeneous enhancement.The diagnosis depends on pathological examination, and antifungal therapy can be considered after adrenalectomy.
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spelling doaj.art-4b0a0e6e73ba4bd59ad999587af70a122023-05-16T09:34:03ZzhoEditorial Office of Journal of Army Medical University陆军军医大学学报2097-09272023-05-0145998999310.16016/j.2097-0927.202211158Adrenocortical insufficiency caused by Cryptococcus neoformans: a case report and literature reviewLIU Hongwei0 LI Shihao1ZHU Yi2GUI Zhiming3XU Zhijian4Department of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, 524001, ChinaDepartment of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, 524001, ChinaDepartment of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, 524001, ChinaDepartment of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, 524001, ChinaDepartment of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, 524001, ChinaObjective To explore the clinical features, diagnosis and treatment regimen of adrenal cryptococcosis so as to improve awareness of this disease for clinicians. Methods The clinical manifestations, laboratory indicators, imaging data and postoperative pathological results of a patient with adrenocortical insufficiency caused by Cryptococcus neoformans infection admitted to our hospital in June 2022 were collected and analyzed, and the related literature was reviewed. Results This patient presented with dizziness, fatigue, and multiple pigmentations throughout the whole body.Upper abdominal plain CT scan on June 24, suggested multiple nodular soft tissue shadows in the bilateral adrenal glands, and the scan on July 1 suggested mild inhomogeneous enhancement of bilateral adrenal nodules, which may be adrenal tumors.Retroperitoneal laparoscopic partial adrenalectomy was performed on July 13.Postoperative pathology indicated cryptococcosis.The antifungal treatment with itraconazole was stopped after 2 weeks by himself.In 3 months after the operation, CT revealed multiple adrenal masses on both sides, and itraconazole was taken again for treatment. Conclusion Patients with adrenal cryptococcosis usually have symptoms of adrenocortical insufficiency such as dizziness, fatigue, and multiple pigmentations throughout the whole body.Abdominal enhanced CT usually indicates adrenal nodules with inhomogeneous enhancement.The diagnosis depends on pathological examination, and antifungal therapy can be considered after adrenalectomy. http://aammt.tmmu.edu.cn/html/202211158.htmcryptococcus neoformansdisseminated cryptococcosisadrenal glandadrenocortical insufficiency
spellingShingle LIU Hongwei
LI Shihao
ZHU Yi
GUI Zhiming
XU Zhijian
Adrenocortical insufficiency caused by Cryptococcus neoformans: a case report and literature review
陆军军医大学学报
cryptococcus neoformans
disseminated cryptococcosis
adrenal gland
adrenocortical insufficiency
title Adrenocortical insufficiency caused by Cryptococcus neoformans: a case report and literature review
title_full Adrenocortical insufficiency caused by Cryptococcus neoformans: a case report and literature review
title_fullStr Adrenocortical insufficiency caused by Cryptococcus neoformans: a case report and literature review
title_full_unstemmed Adrenocortical insufficiency caused by Cryptococcus neoformans: a case report and literature review
title_short Adrenocortical insufficiency caused by Cryptococcus neoformans: a case report and literature review
title_sort adrenocortical insufficiency caused by cryptococcus neoformans a case report and literature review
topic cryptococcus neoformans
disseminated cryptococcosis
adrenal gland
adrenocortical insufficiency
url http://aammt.tmmu.edu.cn/html/202211158.htm
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AT lishihao adrenocorticalinsufficiencycausedbycryptococcusneoformansacasereportandliteraturereview
AT zhuyi adrenocorticalinsufficiencycausedbycryptococcusneoformansacasereportandliteraturereview
AT guizhiming adrenocorticalinsufficiencycausedbycryptococcusneoformansacasereportandliteraturereview
AT xuzhijian adrenocorticalinsufficiencycausedbycryptococcusneoformansacasereportandliteraturereview