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Published on: September 15, 2017
Adrenal infections update: how radiologists can contribute to patient care
Jorge Abreu-Gomez1,2, Vanessa Murad1,2, Shereen Ezzat3
1Department of Medical Imaging, University of Toronto, Toronto, ON M5G 2M9, Canada.
Abstract:
Adrenal infections are considered clinically important but often go unrecognized, with a significant number of cases only diagnosed post-mortem. The limited evidence regarding imaging findings in the literature emphasizes the need to detect and diagnose these infections early in disease course to improve patient outcomes. A range of microorganisms, including fungi, viruses, parasites, and bacteria, can directly or indirectly affect the morphology and function of the adrenal glands. When evaluating a patient with adrenal infection, several immunological and hormonal factors should be considered, such as the status of the hypothalamic-pituitary-adreno cortical axis and the serum cortisol level. Moreover, certain microorganisms specifically target one of the zones of the adrenal glands or vascular supply, resulting in distinct imaging manifestations. The purpose of this article is to describe the fundamental clinical features and imaging manifestations associated with adrenal infections, enabling radiologists to make informed interpretations and contribute to accurate diagnostic assessments.
Insights
Adrenal infections are often missed, leading to delayed diagnosis. This review highlights key imaging findings for early detection and improved patient outcomes in adrenal gland infections.
Area of Science:
- Radiology
- Infectious Diseases
- Endocrinology
Background:
- Adrenal infections are clinically significant but frequently undiagnosed until autopsy.
- Limited literature exists on imaging findings, necessitating early detection strategies.
- Infections can be caused by fungi, viruses, parasites, and bacteria, impacting adrenal morphology and function.
Purpose of the Study:
- To outline the clinical features and imaging manifestations of adrenal infections.
- To aid radiologists in accurate interpretation and diagnosis of adrenal infections.
- To emphasize the importance of early diagnosis for improved patient outcomes.
Main Methods:
- Review of existing literature on adrenal infections and their imaging characteristics.
- Correlation of microbial agents with specific adrenal gland involvement.
- Consideration of immunological and hormonal factors in patient evaluation.
Main Results:
- Diverse microorganisms can affect the adrenal glands.
- Specific infections may target adrenal zones or vascular supply, presenting distinct imaging patterns.
- Understanding these patterns is crucial for differential diagnosis.
Conclusions:
- Early recognition of adrenal infections through imaging is vital.
- Radiologists play a key role in identifying subtle imaging findings.
- Comprehensive evaluation including hormonal status is recommended.
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