Multiple Opportunistic Infections Related to Hypercortisolemia due to Adrenocortical Carcinoma: A Case Report

• Published in: Infection & chemotherapy Vol. 53; no. 4; pp. 797 - 801
• Main Authors: Song, Byeong Geun, Lim, Min Gi, Bae, Joo Hwan, Hong, Joo Hyun, Lee, Sang-Geul, Park, Se Hoon, Kang, Cheol-In
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Infectious Diseases and Korean Society for Chemotherapy 01.12.2021; 대한감염학회
• Subjects: Case Report; 내과학; Infection; Adrenal cortical carcinoma; Pneumonia; Cushing's syndrome
• ISSN: 2093-2340; 2092-6448
• DOI: 10.3947/ic.2020.0205

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 (MRSA) bacteremia accompanied by septic pneumonia. We admitted her to the intensive care unit and treated her for invasive pulmonary aspergillosis (IPA), pneumonia (PJP), candidemia, and 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.