Open AccessMultiple Opportunistic Infections Related to Hypercortisolemia due to Adrenocortical Carcinoma: A Case Report
Author(s) -
Byeong Geun Song,
Min Gi Lim,
Joo Hwan Bae,
Jeong Hee Hong,
Sang Geul Lee,
Se Hoon Park,
Cheol-In Kang
Publication year - 2021
Publication title -
infection and chemotherapy/gam'yeom gwa hwahag yo'beob/infection and chemotherapy
Language(s) - English
Resource type - Journals
eISSN - 2092-6448
pISSN - 1598-8112
DOI - 10.3947/ic.2020.0205
Subject(s) - medicine , hypercortisolemia , bacteremia , pneumonia , adrenocortical carcinoma , opportunistic infection , stenotrophomonas maltophilia , blood culture , antibiotics , intensive care medicine , immunology , hydrocortisone , pseudomonas aeruginosa , microbiology and biotechnology , human immunodeficiency virus (hiv) , genetics , viral disease , bacteria , biology
Cushing's syndrome is characterized by excessive cortisol and immuno-suppression. We experienced a case of Cushing's syndrome caused by adrenocortical carcinoma that was complicated by multiple opportunistic infections. A 37-year-old woman with adrenocortical carcinoma (ACC) presented with decreased mental ability and high fever one week after undergoing chemotherapy. Her initial blood culture revealed methicillin-resistant Staphylococcus aureus (MRSA) bacteremia accompanied by septic pneumonia. We admitted her to the intensive care unit and treated her for invasive pulmonary aspergillosis (IPA), Pneumocystis jirovecii pneumonia (PJP), candidemia, and Stenotrophomonas maltophilia pneumonia with broad-spectrum antibiotics and antifungal agents. Nevertheless, her clinical course worsened and she died. Herein, we report a case of Cushing's syndrome associated with cortisol-secreting ACC that presented with multiple opportunistic infections, including MRSA bacteremia, septic pneumonia, candidemia, PJP, and IPA, illuminating a relationship between hypercortisolemia and opportunistic infections.