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Cited by 15 publications
(7 citation statements)
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“…Correct preoperative diagnosis of adrenal histoplasmosis may obviate the need for surgery while early treatment with antifungal therapy may restore adrenal reserve. In patients with adrenal insufficiency, treatment with corticosteroids may be promptly started without a complete laboratory diagnosis of adrenal insufficiency from blood cortisol level and low aCTH-stimulated cortisol responses (13). among patients with adrenal insufficiency, a large proportion requires replacement therapy, although reversal of adrenal dysfunction has been described after prolonged antifungal treatment.…”
mentioning
confidence: 99%
“…Correct preoperative diagnosis of adrenal histoplasmosis may obviate the need for surgery while early treatment with antifungal therapy may restore adrenal reserve. In patients with adrenal insufficiency, treatment with corticosteroids may be promptly started without a complete laboratory diagnosis of adrenal insufficiency from blood cortisol level and low aCTH-stimulated cortisol responses (13). among patients with adrenal insufficiency, a large proportion requires replacement therapy, although reversal of adrenal dysfunction has been described after prolonged antifungal treatment.…”
mentioning
confidence: 99%
“…Symptoms of adrenal insufficiency include fever, malaise, orthostatic hypotension, nausea, vomiting, hyperkalemia, hyponatremia, eosinophilia, hyperpigmentation, and night sweats and must be recognized and addressed immediately with glucocorticoid and mineralocorticoid therapy to prevent severe, life-threatening complications [7], [11], [12], [13]. However, this syndrome is uncommon [4], [14], [15]. This is due to the fact that disseminated disease usually causes patients to seek medical attention much earlier than the time needed for the 90% destruction of both adrenal glands necessary for the manifestation of clinical adrenal insufficiency [16].…”
Section: Discussionmentioning
confidence: 99%
“…[12] The fungus has a predilection for the reticuloendothelial system mainly lymph nodes, spleen, and liver. [3] The disease may be classified as acute, chronic, and disseminated. [4] Majority of cases infected with Histoplasma remain asymptomatic.…”
Section: Discussionmentioning
confidence: 99%
“…In overwhelming acute invasion by the histoplasma, the presentation is usually a catastrophic event such as an acute adrenal crisis. [3] However, chronic forms present as subtle features of adrenal insufficiency such as lethargy, hyperpigmentation, weight loss, and gastrointestinal symptoms. Treatment of adrenal histoplasmosis includes antifungals given over a variable period of 6 months to 2 years.…”
Section: Introductionmentioning
confidence: 99%