Disseminated cryptococcosis presenting with adrenal insufficiency and meningitis: resistant to prolonged antifungal therapy but responding to bilateral adrenalectomy

Intern Med. 1992 Dec;31(12):1401-5. doi: 10.2169/internalmedicine.31.1401.

Abstract

A case of disseminated cryptococcosis with features of primary adrenal insufficiency and meningitis in an immunocompetent host is presented. Despite antifungal chemotherapy, neither meningitis nor bilateral adrenal gland enlargement was improved. Aspiration biopsy of the adrenal gland revealed necrotic tissue with numerous fungi, suggesting that the adrenal glands were the focus of the persistent fungemia. Removal of bilateral adrenal glands led to improvement by making the patient more sensitive to antifungal chemotherapy.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Gland Diseases / diagnosis*
  • Adrenal Gland Diseases / drug therapy
  • Adrenal Gland Diseases / surgery
  • Adrenalectomy
  • Antifungal Agents / therapeutic use
  • Cryptococcosis / diagnosis*
  • Cryptococcosis / drug therapy
  • Cryptococcosis / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Meningitis, Cryptococcal / diagnosis*
  • Meningitis, Cryptococcal / drug therapy
  • Meningitis, Cryptococcal / surgery
  • Middle Aged
  • Tomography, X-Ray Computed

Substances

  • Antifungal Agents