Authors: Agarwal, Jyotsna¹; Agarwal, Gaurav²; Ayyagari, Archana³; Kar, Dileep²; Mishra, Saroj²; Bhatia, Eesh⁴

Source: Endocrine Pathology, Volume 12, Number 1, March 2001 , pp. 87-91(5)

Publisher: Humana Press

Abstract:

Pneumocystis carinii is primarily an opportunistic pathogen infecting patients with AIDS and other immunocompromised patients, and ordinarily does not affect immunocompetent persons. We report isolated P. carinii infection of bilateral adrenal glands in a non-immunocompromised adult male, leading to fatal Addisonian crisis. Diagnosis of P. carinii was established on the basis of cytopathology and microbiological tests, using conventional staining techniques and direct immunofluorescence on ultrasound-guided fine needle aspirates and trucut needle biopsy specimen from adrenal glands. P. carinii pneumonia and other fungal infections of the adrenal glands were excluded by appropriate tests. Absence of HIV infection was established by negative ELISA for HIV I and II antibodies and Western blot analysis at the time of presentation and 45 d later. Normal blood total leukocyte and CD4 lymphocyte counts and IgG and IgA levels confirmed the immunocompetent status of the patient. The patient improved with anti-Pneumocystis treatment and corticosteroid replacement, but succumbed to an episode of Addisonian crisis triggered by a diarrheal illness.

Keywords: Pneumocystis carinii; Pneumocystis carinii infections; adrenal gland diseases; Addison's disease

Document Type: Research article

DOI: http://dx.doi.org/10.1385/EP:12:1:87

Affiliations: 1: Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, 226 014, Lucknow, India, 2: Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, 226 014, Lucknow, India, 3: Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, 226 014, Lucknow, India, Email: archana@sgpgi.ac.in 4: Department of Endorinology (EB), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, 226 014, Lucknow, India,

Publication date: 2001-03-01

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