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Case Reports
Disseminated Cryptococcosis with Adrenal Insufficiency and Meningitis in an Immunocompetent Individual.
- Misa Ito, Takashi Hinata, Kaku Tamura, Ayano Koga, Toshimitsu Ito, Hiroko Fujii, Fumihiko Hirata, and Hidenari Sakuta.
- Department of Internal Medicine, Japan Self Defense Forces Central Hospital, Japan.
- Intern. Med. 2017 Jan 1; 56 (10): 125912641259-1264.
AbstractWe present a case of cryptococcosis with adrenal insufficiency and meningitis in a healthy host without any risk factors. Antifungal therapy did not reduce the cryptococcal antigen titers of the cerebrospinal fluid and serum or the bilateral adrenal gland enlargement. It was suggested that the adrenal glands were the focus of persistent fungemia. Removal of both adrenal glands brought about a response to antifungal therapy. We conclude that if antifungal therapy is ineffective, bilateral adrenalectomy is an effective measure for treatment of such patients. Cryptococcosis is a possible cause of primary adrenal insufficiency in immunocompetent patients.
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