Bilateral adrenal masses secondary to fungal infiltration in an immuno-competent host
We presented a 54 year old gentleman, non-diabetic or hypertensive, presented with chronic headache worse in the afternoon, associated with late afternoon lethargy, loss of weight and loss of appetitefor 2 months duration. At presentation he was hypotensive, hyponatremic with relative hyperkalem...
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iium-481122018-06-12T02:31:11Z http://irep.iium.edu.my/48112/ Bilateral adrenal masses secondary to fungal infiltration in an immuno-competent host Shahar, Mohammad Arif Omar, Ahmad Marzuki Rajoo, Subashini Loh , Huai Heng Ooi, Chew Peng Wan Seman, Wan Juani Omar, Mohd Rahman A Wahab, Norasyikin Mustafa, Norlaila Sukor , Norlela Kamaruddin, Nor Azmi RC Internal medicine We presented a 54 year old gentleman, non-diabetic or hypertensive, presented with chronic headache worse in the afternoon, associated with late afternoon lethargy, loss of weight and loss of appetitefor 2 months duration. At presentation he was hypotensive, hyponatremic with relative hyperkalemia and low normal blood sugar. Six a.m. cortisol was 160 mmol/L. His hypotension and hyponatremia resolved after administration of intravenous hydrocortisone 100mg tid. Computed tomography (CT) of the adrenalsrevealedbilateral adrenal masses measuring 6.2 cm (largest diameter) on the left side and 5.0 cm on the right side (figure 1). CT guided biopsy of the adrenal mass revealed the presence of necrotic tissue with fungal bodies (figure 2 and figure 3). Retroviral screen was negative. On further questioning, the patient had been nursing an owl and had been handling its droppings 2 months prior to the onset of symptoms. This case illustrates the rare occurrence of bilateral adrenal mass from fungal infiltrationcausing adrenal insufficiency in an immuno-competent host with possible zoonosis from an owl. Malaysian Endocrine and Metabolic Society 2014-05 Article PeerReviewed application/pdf en http://irep.iium.edu.my/48112/6/PP-046.pdf Shahar, Mohammad Arif and Omar, Ahmad Marzuki and Rajoo, Subashini and Loh , Huai Heng and Ooi, Chew Peng and Wan Seman, Wan Juani and Omar, Mohd Rahman and A Wahab, Norasyikin and Mustafa, Norlaila and Sukor , Norlela and Kamaruddin, Nor Azmi (2014) Bilateral adrenal masses secondary to fungal infiltration in an immuno-competent host. Journal of Endocrinology and Metabolism, 4 (1(Sup)). p. 30. ISSN 2229-9572 http://www.jmems.org/index.php/jmems/issue/view/5 |
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RC Internal medicine |
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RC Internal medicine Shahar, Mohammad Arif Omar, Ahmad Marzuki Rajoo, Subashini Loh , Huai Heng Ooi, Chew Peng Wan Seman, Wan Juani Omar, Mohd Rahman A Wahab, Norasyikin Mustafa, Norlaila Sukor , Norlela Kamaruddin, Nor Azmi Bilateral adrenal masses secondary to fungal infiltration in an immuno-competent host |
description |
We presented a 54 year old gentleman, non-diabetic or hypertensive,
presented with chronic headache worse in the afternoon, associated with
late afternoon lethargy, loss of weight and loss of appetitefor 2 months
duration. At presentation he was hypotensive, hyponatremic with relative
hyperkalemia and low normal blood sugar. Six a.m. cortisol was 160
mmol/L. His hypotension and hyponatremia resolved after administration
of intravenous hydrocortisone 100mg tid. Computed tomography (CT) of
the adrenalsrevealedbilateral adrenal masses measuring 6.2 cm (largest
diameter) on the left side and 5.0 cm on the right side (figure 1). CT guided
biopsy of the adrenal mass revealed the presence of necrotic tissue with
fungal bodies (figure 2 and figure 3). Retroviral screen was negative. On
further questioning, the patient had been nursing an owl and had been
handling its droppings 2 months prior to the onset of symptoms. This
case illustrates the rare occurrence of bilateral adrenal mass from fungal
infiltrationcausing adrenal insufficiency in an immuno-competent host with
possible zoonosis from an owl. |
format |
Article |
author |
Shahar, Mohammad Arif Omar, Ahmad Marzuki Rajoo, Subashini Loh , Huai Heng Ooi, Chew Peng Wan Seman, Wan Juani Omar, Mohd Rahman A Wahab, Norasyikin Mustafa, Norlaila Sukor , Norlela Kamaruddin, Nor Azmi |
author_facet |
Shahar, Mohammad Arif Omar, Ahmad Marzuki Rajoo, Subashini Loh , Huai Heng Ooi, Chew Peng Wan Seman, Wan Juani Omar, Mohd Rahman A Wahab, Norasyikin Mustafa, Norlaila Sukor , Norlela Kamaruddin, Nor Azmi |
author_sort |
Shahar, Mohammad Arif |
title |
Bilateral adrenal masses secondary to fungal infiltration
in an immuno-competent host |
title_short |
Bilateral adrenal masses secondary to fungal infiltration
in an immuno-competent host |
title_full |
Bilateral adrenal masses secondary to fungal infiltration
in an immuno-competent host |
title_fullStr |
Bilateral adrenal masses secondary to fungal infiltration
in an immuno-competent host |
title_full_unstemmed |
Bilateral adrenal masses secondary to fungal infiltration
in an immuno-competent host |
title_sort |
bilateral adrenal masses secondary to fungal infiltration
in an immuno-competent host |
publisher |
Malaysian Endocrine and Metabolic Society |
publishDate |
2014 |
url |
http://irep.iium.edu.my/48112/ http://irep.iium.edu.my/48112/ http://irep.iium.edu.my/48112/6/PP-046.pdf |
first_indexed |
2023-09-18T21:08:20Z |
last_indexed |
2023-09-18T21:08:20Z |
_version_ |
1777411083583094784 |