ABSTRACT
Staphylococcus pseudintermedius colonizes and is a pathogen of dogs and is being increasingly recognized from specimens from humans with various infections. We describe a case of S. pseudintermedius bacteremia in a 4 month old pediatric oncology patient with clear evidence of transmission from the family pet.
Subject(s)
Adrenal Gland Neoplasms/microbiology , Bacteremia/transmission , Dog Diseases/transmission , Neuroblastoma/microbiology , Pets/microbiology , Staphylococcal Infections/transmission , Staphylococcus/isolation & purification , Adrenal Gland Neoplasms/drug therapy , Animals , Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Bacteremia/microbiology , Dog Diseases/microbiology , Dogs , Humans , Infant , Male , Neuroblastoma/drug therapy , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiology , Staphylococcus/drug effectsABSTRACT
Isolated adrenal tuberculosis accounts for less than 2% of adrenal incidentalomas. This is the most frequent infectious cause of adrenal insufficiencies. We report the case of a 53-year old patient with no previous medical history presenting with adrenal insufficiency with slow progression over six months. Physical examination didn't show any mass or hepatosplenomegaly. Blood pressure was 120/60 mmHg. Laboratory tests didn't show inflammatory syndrome. LDH level was normal. CT scan showed bilateral hypertrophy of the adrenal glands characterized by calcifications. Intradermo tuberculin reaction was positive at 25mm. The analyses to detect Koch's bacillus in the sputum and in the urine were negative. Quantiferon® test was positive. Trial antibacillar treatment was started with clinical improvement and 5kg weight gain in 12 months. Hormonal assays were low.
Subject(s)
Adrenal Gland Diseases/diagnosis , Adrenal Gland Neoplasms/diagnosis , Adrenal Insufficiency/diagnosis , Antitubercular Agents/administration & dosage , Tuberculosis, Endocrine/diagnosis , Adrenal Gland Diseases/drug therapy , Adrenal Gland Diseases/microbiology , Adrenal Gland Neoplasms/microbiology , Adrenal Insufficiency/microbiology , Disease Progression , Humans , Interferon-gamma Release Tests , Male , Middle Aged , Treatment Outcome , Tuberculosis, Endocrine/drug therapyABSTRACT
Pheochromocytoma is a neoplasm, which develops from cells of the chromaffin tissues that are derived from the ectodermic neural system and mostly situated within the adrenal medulla. Approximately 15% of pheochromocytoma cases arise from extra-adrenal chromaffin tissue. Pheochromocytoma of the bladder is rare and accounts for less than 0.06% of all bladder neoplasms and less than 1% of all pheochromocytomas. We report a case of a young woman who presented with uncontrolled hypertension, recurrent urinary tract infections and micturition attacks and was found to have a metastatic bladder paraganglioma. In addition, we provide a summary table of the clinical manifestations of paragangliomas based on anatomic locations.
Subject(s)
Adrenal Gland Neoplasms , Hypertension , Urinary Bladder Neoplasms , Urinary Tract Infections , Adrenal Gland Neoplasms/microbiology , Adrenal Gland Neoplasms/pathology , Adrenal Gland Neoplasms/physiopathology , Adult , Female , Humans , Hypertension/microbiology , Hypertension/pathology , Hypertension/physiopathology , Neoplasm Metastasis , Pheochromocytoma/microbiology , Pheochromocytoma/pathology , Pheochromocytoma/physiopathology , Pheochromocytoma/secondary , Urinary Bladder Neoplasms/microbiology , Urinary Bladder Neoplasms/pathology , Urinary Bladder Neoplasms/physiopathology , Urinary Tract Infections/microbiology , Urinary Tract Infections/pathology , Urinary Tract Infections/physiopathologyABSTRACT
A 53-year-old woman experienced progressive general weakness and lumbago in the 2 years prior to a physical examination which disclosed cushingoid manifestations and a skin ulcer on the back of her right knee joint. Her plasma cortisol concentration ranged from 24.7 to 31.1 microg/dl, with an ACTH level <5 pg/ml. Urinary excretions of 17-hydroxycorticosteroid (17-OHCS) and 17-ketosteroid (17-KS) were 20.5 mg/day and 5.1 mg/day, respectively, and urinary cortisol was also increased (421 microg/day). Cortisol was not suppressed after the administration of 8 mg dexamethasone. Abdominal ultrasound sonography, computed tomography (CT) scan, and magnetic resonance imaging (MRI) studies demonstrated a left adrenal tumor and further, a chest X-ray examination showed a cavitary lesion containing a fungus ball-like mass in the left lower lung field. The serum cryptococcal antigen titer was positive at 1:128 and a bronchoalveolar lavage fluid culture yielded a growth of Cryptococcus neoformans. A biopsy specimen of the skin ulcer also suggested cryptococcosis. As a result, a left adrenectomy was performed, and the excised specimen was shown to be an adenoma consisting of compact cells with abundant pigmentation (black adenoma). A diagnosis of functioning black adenoma of the adrenal gland, complicated with pulmonary and cutaneous cryptococcosis was made.
Subject(s)
Adrenal Gland Neoplasms/microbiology , Adrenocortical Adenoma/microbiology , Cryptococcosis/complications , Lung Diseases, Fungal/complications , Skin Diseases, Infectious/complications , Female , Humans , Middle AgedABSTRACT
A high incidence of adrenal tumors was observed in aged female NIH Swiss mice which had been ovariectomized at 2 to 4 weeks of age but not in nonovariectomized controls. Although tumors weighing more than 1 g were not infrequent in the oldest (> 24 months) animals, adrenal glands did not appear macroscopically abnormal before the age of 18 months. Histologically, however, focal or diffuse abnormalities were found in essentially every gland examined from mice over 12 months of age, including glands of normal size. Since the NIH Swiss mouse has been shown to contain an endogenous xenotropic virus whose expression is under hormonal control, the adrenal tumors were examined in detail for evidence of abnormal viral expression. We were unable, by a variety of techniques, to demonstrate elevated expression of type C virus in these adrenal tumors.