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Bilateral adrenal masses secondary to fungal infiltration in an immuno-competent host

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

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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.

Item Type: Article (Journal)
Additional Information: 5471/48112
Uncontrolled Keywords: Bilateral adrenal masses
Subjects: R Medicine > RC Internal medicine
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine > Department of Internal Medicine
Depositing User: Mrs Noor Azlin Asnam
Date Deposited: 18 Mar 2016 14:12
Last Modified: 12 Jun 2018 10:31
URI: http://irep.iium.edu.my/id/eprint/48112

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