Pseudotumoral pulmonary cryptococcosis in association with Cushing's syndrome

Opportunistic infections in endogenous Cushing's syndrome are associated with severe cortisol excess and carry a high mortality. Pulmonary cryptococcosis is one of these opportunistic infections and can mimic a lung neoplasm, therefore making its diagnosis difficult. We report a case of a young...

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Bibliographic Details
Published in:Arquivos brasileiros de endocrinologia e metabologia 2004-04, Vol.48 (2), p.318-323
Main Authors: Lacativa, Paulo G S, Donangelo, Ines, Wagman, Márcia B, Sieiro Neto, Lino, Caldas, Carolina R, Violante, Alice H D, Lima, Roberto J, Vaisman, Mário
Format: Article
Language:Portuguese
Subjects:
Adult
Cryptococcosis - complications
Cryptococcosis - diagnosis
Cushing Syndrome - complications
Diagnosis, Differential
Fatal Outcome
Humans
Lung Diseases, Fungal - complications
Lung Diseases, Fungal - diagnosis
Lung Neoplasms - diagnosis
Male
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Summary:Opportunistic infections in endogenous Cushing's syndrome are associated with severe cortisol excess and carry a high mortality. Pulmonary cryptococcosis is one of these opportunistic infections and can mimic a lung neoplasm, therefore making its diagnosis difficult. We report a case of a young male with ACTH-dependent Cushing's syndrome and severe hypercortisolism. The patient achieved cure after the transfenoidal surgery, but developed a febrile state. A chest computed tomography showed a pulmonary nodule that did not change in serial chest radiographs. Diagnosis of tuberculosis, fungal and bacterial infections were inconclusive, so the hypothesis of lung neoplasm became more probable. The necropsy, however, disclosed a pseudotumoral cryptococcosis. Opportunistic infections, like Cryptococcus neoformans, should be considered in patients with Cushing's syndrome and a pulmonary infiltrate.
ISSN:0004-2730