18F-FDG PET/CT Imaging in Adrenal Cryptococcosis

Area of Science:

• Infectious Diseases
• Mycology
• Endocrinology

Background:

• Cryptococcosis is a fungal infection primarily affecting immunocompromised individuals.
• Disseminated cryptococcosis, especially isolated adrenal involvement, is exceptionally rare in immunocompetent hosts.
• Central nervous system (CNS) involvement is a common manifestation of cryptococcal dissemination.

Observation:

• An immunocompetent patient presented with symptoms suggestive of adrenal insufficiency.
• Imaging revealed bilateral adrenal involvement consistent with cryptococcosis.
• No evidence of central nervous system involvement was detected.

Findings:

• The patient was diagnosed with bilateral adrenal cryptococcosis and resultant adrenal insufficiency.
• F-18 fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (F-FDG PET/CT) accurately identified residual disease.
• This case represents a rare occurrence of cryptococcosis isolated to the adrenal glands in an immunocompetent individual.

Implications:

• This case expands the understanding of cryptococcosis presentation in immunocompetent individuals.
• F-FDG PET/CT demonstrates utility in detecting residual adrenal fungal infections.
• Highlights the importance of considering fungal infections in adrenal insufficiency, even in immunocompetent patients.