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[Fever, somnolence, vomiting, diarrhea].
U Schotte1, R Caduff, C Meyenberger
1Departement für Innere Medizin, Medizinische Poliklinik, Universitätsspital Zürich.
Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|December 4, 1990
Summary
An acute infection triggered an Addisonian crisis in a patient with known Addison's disease. Further investigation revealed sigmoid and salpinx cancers, successfully treated with surgery.
Area of Science:
- Endocrinology
- Infectious Diseases
- Oncology
Background:
- Addison's disease, a chronic endocrine disorder, can precipitate an Addisonian crisis.
- Acute infections are common triggers for Addisonian crisis, especially in patients with a history of adrenal tuberculosis.
Observation:
- A 69-year-old female presented with symptoms of febrile state, somnolence, nausea, and diarrhea, indicative of an Addisonian crisis.
- Streptococcus bovis was identified as the causative agent of the acute infection.
Findings:
- The patient's Addisonian crisis resolved rapidly with steroid therapy and electrolyte/fluid replacement.
- Investigation for Streptococcus bovis revealed sigmoid and incidental salpinx cancers, both surgically removed.
- The patient remained asymptomatic post-surgery with continued steroid replacement therapy.
Implications:
- This case highlights the critical link between infections and Addisonian crisis in patients with Addison's disease.
- It underscores the importance of investigating potential underlying malignancies, such as colon and salpinx cancer, in patients presenting with S. bovis bacteremia.
- Early diagnosis and management of both the endocrine crisis and associated cancers are crucial for patient outcomes.