Song Byeong Geun, Lim Min Gi, Bae Joo Hwan, Hong Joo Hyun, Lee Sang-Geul, Park Se Hoon, Kang Cheol-In
Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Korea.
Division of Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University of School of Medicine, Seoul, Korea.
Infect Chemother. 2021 Dec;53(4):797-801. doi: 10.3947/ic.2020.0205. Epub 2020 Aug 12.
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.
