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Updated: Jan 28, 2026
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Macrophage Cholesterol Depletion and Its Effect on the Phagocytosis of Cryptococcus neoformans
Published on: December 19, 2014
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Insuficiencia suprarrenal por criptococosis diseminada en un individuo inmunocompetente
Jeremy A Knott1,2, Zoran Apostoloski1
1Department of Endocrinology, Wollongong Hospital, Sydney, NSW, Australia, nsw.gov.au.
Case reports in endocrinology
|January 26, 2026
Resumen
La insuficiencia suprarrenal primaria es rara en pacientes inmunocompetentes. Este caso destaca la criptococosis diseminada que causa insuficiencia suprarrenal, enfatizando el diagnóstico temprano y el tratamiento antifúngico para mejores resultados.
Área de la Ciencia:
- Enfermedades Infecciosas
- Endocrinología
- Radiología
Sus antecedentes:
- La insuficiencia suprarrenal primaria es infrecuente debido a infecciones fúngicas, especialmente en individuos inmunocompetentes.
- Las infecciones fúngicas diseminadas pueden infiltrar las glándulas suprarrenales, provocando insuficiencia suprarrenal.
Objetivo del estudio:
- Informar un caso raro de insuficiencia suprarrenal causada por Cryptococcus neoformans en un paciente inmunocompetente.
- Enfatizar las consideraciones diagnósticas y terapéuticas para la criptococosis diseminada que se presenta como insuficiencia suprarrenal.
Principales métodos:
- Presentación de caso de un hombre inmunocompetente de 61 años con síntomas de insuficiencia suprarrenal.
- El estudio diagnóstico incluyó TC suprarrenal, FDG-PET, biopsias suprarrenales, análisis de antígeno criptocócico sérico (Ag-Cr) y análisis del líquido cefalorraquídeo.
- El tratamiento incluyó hidrocortisona, fludrocortisona, anfotericina B liposomal, 5-flucitosina y fluconazol.
Principales resultados:
- El paciente presentó fatiga, pérdida de peso, mareos, hiponatremia e hiperpotasemia.
- Las imágenes revelaron agrandamiento suprarrenal bilateral con necrosis central.
- Las biopsias suprarrenales confirmaron la infección por Cryptococcus; el Ag-Cr y el análisis del LCR fueron positivos.
- Los síntomas mejoraron con reemplazo hormonal y terapia antifúngica.
Conclusiones:
- La criptococosis diseminada debe considerarse en pacientes inmunocompetentes con insuficiencia suprarrenal.
- El diagnóstico rápido y la terapia antifúngica apropiada son críticos para el manejo de esta condición.
- Este caso subraya la importancia de un enfoque diagnóstico integral para la insuficiencia suprarrenal de etiología no clara.
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