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KMID : 1144320210530040797
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감염과 화학요법
2021 Volume.53 No. 4 p.797 ~ p.801
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Multiple Opportunistic Infections Related to Hypercortisolemia due to Adrenocortical Carcinoma: A Case Report
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Song Byeong-Geun
Lim Min-Gi
Bae Joo-Hwan
Hong Joo-Hyun
Lee Sang-Geul
Park Se-Hoon
Kang Cheol-In
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Abstract
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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 Staphylococcus aureus (MRSA) bacteremia accompanied by septic pneumonia. We admitted her to the intensive care unit and treated her for invasive pulmonary aspergillosis (IPA), Pneumocystis jirovecii pneumonia (PJP), candidemia, and Stenotrophomonas maltophilia 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.
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KEYWORD
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Cushing's syndrome, Adrenal cortical carcinoma, Infection, Pneumonia
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