Case Report Bilateral Adrenal Enlargement due to Histoplasmosis in A Man Who Closely Contacts with Chicken
Keywords:
Histoplasma capsulatum, Disseminated histoplasmosis, Adrenal enlargementAbstract
Histoplasma capsulatum, a fungus that causes systemic infection that are common in Thailand. It causes a wide spectrum of illness from asymptomatic infection to disseminated disease especially among mmunocompromised patients that fatal if untreated. Disseminated histoplasmosis in immunocompetent persons is quite uncommon. Adrenal gland is affected frequently in disseminated histoplasmosis but
isolated adrenal gland involvement is rare. This report shows a man who closely contacted with the chicken for about 1 year and suddenly died in his room. Autopsy report revealed well-circumscribed bilateral adrenal enlargement. Together with the results of pathology and toxicology investigation concluded that the cause of death due to adrenal insufficiency from adrenal histoplasmosis. This encourages clinicians in endemic area to be aware of this disease in patients presenting with chronic fatigue syndrome for the proper management, as well as forensic physicians in cases of unknown cause of death and autopsy revealing adrenal gland enlargement for proper investigation to find out the definite cause of death.
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