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Unilateral active adrenal tuberculosis featuring persistent intermittent fever.

Aki Ikoma1, Kazuyuki Namai, Tomoyuki Saito

  • 1Department of Medicine, Jichi Medical School Omiya Medical Center, Saitama, Japan.

Endocrine Journal
|November 2, 2004
PubMed
Summary

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This case study highlights a rare instance of active unilateral adrenal tuberculosis presenting solely as intermittent fever. Early detection and treatment of this atypical presentation are crucial for patient recovery.

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Pathology

Background:

  • Tuberculosis (TB) can affect the adrenal glands, often diagnosed late due to adrenal insufficiency.
  • Active adrenal tuberculosis is infrequently identified during infectious disease screenings.
  • Bilateral adrenal involvement is more commonly recognized than unilateral cases.

Observation:

  • A 68-year-old male presented with a 3-month history of intermittent fever, leukocytosis, and elevated C-reactive protein.
  • Extensive bacterial and Mycobacterium tuberculosis cultures were negative, and tuberculin reaction was absent.
  • Imaging revealed a right adrenal mass, later confirmed as active adrenal tuberculosis post-adrenalectomy.

Findings:

  • Histological examination confirmed active unilateral adrenal tuberculosis as the cause of the patient's symptoms.

Related Experiment Videos

  • Post-surgical resolution of fever and normalization of inflammatory markers were observed.
  • The case presented without evidence of adrenal insufficiency or other organ involvement.

    • Implications:

    • This case underscores the importance of considering atypical presentations of adrenal tuberculosis, particularly unilateral forms.
    • It emphasizes the need for thorough investigation in cases of persistent fever with unexplained inflammatory markers.
    • Successful treatment through adrenalectomy highlights a viable therapeutic option for localized adrenal tuberculosis.