Interplay Between Infectious Diseases and the Endocrine System: An Overview and Clinical Insights

Infectious diseases can affect the endocrine system through multiple mechanisms, including direct cytopathic effects, immune dysregulation, inflammatory pathways, and in some cases the secretion of hormone-like substances by the pathogens themselves. While viral and bacterial infections represent the most frequent triggers, fungal and parasitic agents can also contribute, though less commonly.

This narrative review, based on a search in PubMed and Google Scholar, examined both paediatric and adult studies, given the limited evidence available in children. The analysis focused on the pituitary, thyroid, adrenal glands, gonads and endocrine pancreas, summarising current knowledge on the acute and long-term endocrine consequences of infections.

Reported outcomes range from type 1 diabetes mellitus and adrenal insufficiency to hypopituitarism, thyroiditis and hypogonadism. These complications may appear during the acute phase or emerge later as delayed sequelae, with significant implications for prognosis, quality of life and overall morbidity. The review highlights the need for increased clinical awareness, timely recognition of infection-related endocrine dysfunctions, and structured follow-up to prevent long-lasting complications.

Further translational and clinical studies are warranted to clarify underlying mechanisms, identify early biomarkers and develop evidence-based diagnostic and therapeutic strategies, ultimately improving patient care and outcomes in both paediatric and adult populations. In the future, through genomic and transcriptomic techniques, the identification of the dysregulated cellular pathways could help clarify the real 'cause-and-effect' relationship between infections and cellular dysfunction.