Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report
Abstract Background Subclinical Cushing’s disease (SCD) is defined by corticotroph adenoma-induced mild hypercortisolism without typical physical features of Cushing’s disease. Infection is an important complication associated with mortality in Cushing’s disease, while no reports on infection in SCD...
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doaj-6d17aa67fba24c259071cd805bed471f2021-05-02T11:21:02ZengBMCBMC Endocrine Disorders1472-68232021-04-012111610.1186/s12902-021-00757-ySevere infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case reportYuki Yamauchi0Hiraku Kameda1Kazuno Omori2Michio Tani3Kyu Yong Cho4Akinobu Nakamura5Hideaki Miyoshi6Shinya Tanaka7Tatsuya Atsumi8Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Graduate School of Medicine, Hokkaido UniversityDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Graduate School of Medicine, Hokkaido UniversityDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Graduate School of Medicine, Hokkaido UniversityDepartment of Cancer Pathology, Hokkaido University Faculty of MedicineDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Graduate School of Medicine, Hokkaido UniversityDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Graduate School of Medicine, Hokkaido UniversityDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Graduate School of Medicine, Hokkaido UniversityDepartment of Cancer Pathology, Hokkaido University Faculty of MedicineDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Graduate School of Medicine, Hokkaido UniversityAbstract Background Subclinical Cushing’s disease (SCD) is defined by corticotroph adenoma-induced mild hypercortisolism without typical physical features of Cushing’s disease. Infection is an important complication associated with mortality in Cushing’s disease, while no reports on infection in SCD are available. To make clinicians aware of the risk of infection in SCD, we report a case of SCD with disseminated herpes zoster (DHZ) with the mortal outcome. Case presentation An 83-year-old Japanese woman was diagnosed with SCD, treated with cabergoline in the outpatient. She was hospitalized for acute pyelonephritis, and her fever gradually resolved with antibiotics. However, herpes zoster appeared on her chest, and the eruptions rapidly spread over the body. She suddenly went into cardiopulmonary arrest and died. Autopsy demonstrated adrenocorticotropic hormone-positive pituitary adenoma, renal abscess, and DHZ. Conclusions As immunosuppression caused by SCD may be one of the triggers of severe infection, the patients with SCD should be assessed not only for the metabolic but also for the immunodeficient status.https://doi.org/10.1186/s12902-021-00757-ySubclinical Cushing’s diseaseDisseminated herpes zosterInfection |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yuki Yamauchi Hiraku Kameda Kazuno Omori Michio Tani Kyu Yong Cho Akinobu Nakamura Hideaki Miyoshi Shinya Tanaka Tatsuya Atsumi |
spellingShingle |
Yuki Yamauchi Hiraku Kameda Kazuno Omori Michio Tani Kyu Yong Cho Akinobu Nakamura Hideaki Miyoshi Shinya Tanaka Tatsuya Atsumi Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report BMC Endocrine Disorders Subclinical Cushing’s disease Disseminated herpes zoster Infection |
author_facet |
Yuki Yamauchi Hiraku Kameda Kazuno Omori Michio Tani Kyu Yong Cho Akinobu Nakamura Hideaki Miyoshi Shinya Tanaka Tatsuya Atsumi |
author_sort |
Yuki Yamauchi |
title |
Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report |
title_short |
Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report |
title_full |
Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report |
title_fullStr |
Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report |
title_full_unstemmed |
Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report |
title_sort |
severe infection including disseminated herpes zoster triggered by subclinical cushing’s disease: a case report |
publisher |
BMC |
series |
BMC Endocrine Disorders |
issn |
1472-6823 |
publishDate |
2021-04-01 |
description |
Abstract Background Subclinical Cushing’s disease (SCD) is defined by corticotroph adenoma-induced mild hypercortisolism without typical physical features of Cushing’s disease. Infection is an important complication associated with mortality in Cushing’s disease, while no reports on infection in SCD are available. To make clinicians aware of the risk of infection in SCD, we report a case of SCD with disseminated herpes zoster (DHZ) with the mortal outcome. Case presentation An 83-year-old Japanese woman was diagnosed with SCD, treated with cabergoline in the outpatient. She was hospitalized for acute pyelonephritis, and her fever gradually resolved with antibiotics. However, herpes zoster appeared on her chest, and the eruptions rapidly spread over the body. She suddenly went into cardiopulmonary arrest and died. Autopsy demonstrated adrenocorticotropic hormone-positive pituitary adenoma, renal abscess, and DHZ. Conclusions As immunosuppression caused by SCD may be one of the triggers of severe infection, the patients with SCD should be assessed not only for the metabolic but also for the immunodeficient status. |
topic |
Subclinical Cushing’s disease Disseminated herpes zoster Infection |
url |
https://doi.org/10.1186/s12902-021-00757-y |
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