Bilateral adrenal histoplasmosis in a Malaysian tertiary hospital:Report of four cases  

作　　者：Kang WH Norasyikin Abdul Wahab 

机构地区：[1]Department of Medicine,Faculty of Medicine and Health Sciences,University Tunku Abdul Rahman,Malaysia [2]Department of Medicine,Pusat Perubatan Universiti Kebangsaan,Malaysia

出　　处：《Asian Pacific Journal of Tropical Medicine》2024年第2期91-94,共4页亚太热带医药杂志（英文版）

摘　　要：Rationale:Adrenal histoplasmosis can present as bilateral adrenal enlargement with constitutional symptoms and/or adrenal insufficiency.Often these patients are initially investigated as secondary adrenal metastases before eventually their diagnosis established by histopathological examination of the adrenal tissues.Patients concerns:We report 4 cases of patients aged 55-78 who presented with hypocortisolism and bilateral adrenal masses.Diagnoses:Bilateral adrenal histoplasmosis.Interventions:Three patients received antifungal treatment for at least one year while 1 patient passed away before the initiation of antifungal treatment.Outcomes:Two patients’adrenal function recovered not requiring any steroid replacement,while 1 patient still requires long-term steroid replacement.Lessons:Adrenal histoplasmosis should be excluded in patients from endemic areas presenting with bilateral adrenal masses and adrenal insufficiency.Usually patients have an exposure to bird droppings,bat guano or soil contaminated with histoplasmosis fungi.Histopathological examination of biopsied adrenal tissues is still the gold standard investigation as serology and molecular diagnostic methods are still not widely available in most centers in Malaysia.

关 键 词：Adrenal histoplasmosis HISTOPLASMOSIS Bilateral adrenal masses 

分 类 号：R586[医药卫生—内分泌]