Related Experiment Videos
Adrenal histoplasmosis: unusual presentations
Anil Bhansali1, Sambit Das, Pinaki Dutta
1Department of Endocrinology, PGIMER, Chandigarh.
The Journal of the Association of Physicians of India
|June 20, 2013
Summary
Adrenal histoplasmosis, a rare cause of adrenal insufficiency (AI), can present with constitutional symptoms and adrenal masses. Early diagnosis and treatment are crucial for managing this fungal infection.
Area of Science:
- Infectious Diseases
- Endocrinology
- Radiology
Background:
- Histoplasmosis is infrequently reported in India.
- Isolated adrenal involvement causing adrenal insufficiency (AI) is rare, though asymptomatic adrenal involvement is known in disseminated histoplasmosis.
Observation:
- This study describes five immunocompetent men from a nonendemic region presenting with constitutional symptoms and adrenal histoplasmosis.
- Three patients had AI with bilateral adrenal involvement; two developed AI with unilateral adrenal mass during illness.
- All patients had confirmed adrenal histoplasmosis via histopathology/cytology. 18FDG-PET imaging aided in disease staging.
Findings:
- Adrenal histoplasmosis presented with constitutional symptoms and adrenal masses (unilateral or bilateral).
- Adrenal insufficiency (AI) was a key feature, either at presentation or developing during the illness.
- Antifungal treatment (Amphotericin B and/or itraconazole) improved symptoms but AI persisted in all patients.
Implications:
- Consider adrenal histoplasmosis in patients with constitutional symptoms and adrenal masses, with or without AI.
- This fungal infection requires consideration in the differential diagnosis of adrenal lesions, especially in endemic or potentially exposed areas.
- Adrenal insufficiency may persist despite treatment, necessitating long-term management.
Related Concept Videos
01:27Adrenal Gland Disorders
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
01:14Atypical Pneumonia
Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease include...
01:25Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
01:27Myocarditis II: Clinical Features and Diagnostic Tests
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
01:31Pulmonary Tuberculosis III
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...