Adrenal gland abscess due to Streptococcus pneumoniae

Urrutia, Agustín; Santesmases, Javier; Benitez, Rosa; Areal, J.

doi:10.1016/j.jinf.2009.10.050

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…The literature shows that pathogens in adrenal abscesses are diverse (2)(3)(4)(6)(7)(8)(9)(10). Staphylococcus aureus and Escherichia coli are the most common bacteria in acute infection, while Tuberculosis, Nocardia, fungi and parasites are more common in chronic infection.…”

Section: Discussionmentioning

confidence: 99%

“…Adrenal gland infection can develop through either the dissemination of a bloodstream infection or previous extravasated blood in the adrenal gland, which is more common. Staphylococcus aureus and Escherichia coli are the most common pathogens according to the literature (2), and Streptococcus, Salmonella, Bacteroides, Echovirus, Herpes simplex virus, Cytomegalovirus, Nocardia, Tuberculosis, fungi and parasites have also been reported (3)(4)(5)(6). Here, we report a case of adrenal gland abscess caused by multiple pathogens, predominantly mixed anaerobes, identified via metagenomic next-generation sequencing (mNGS) and culturing of Escherichia coli, Proteus mirabilis and Actinomyces turicensis.…”

Section: Introductionmentioning

confidence: 95%

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A rare case of adrenal gland abscess due to anaerobes detected by metagenomic next-generation sequencing

Wu¹,

Miao²,

Wang³

et al. 2020

Ann Transl Med

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A 50-year-old woman presented with right back pain, low fever, leukocytosis, a high level of C-reactive protein and a high erythrocyte sedimentation rate. Abdominal magnetic resonance imaging (MRI) revealed a hypodense lesion in the right suprarenal region, while PET/CT showed mildly increased metabolic activity. A CT-guided percutaneous puncture was performed, and foul-smelling thick pus was removed, which indicated an anaerobic infection. A smear of the pus showed both gram-positive and gramnegative microorganisms. Traditional culture only detected Escherichia coli, Proteus mirabilis, and Actinomyces turicensis. While surprisingly, metagenomic next-generation sequencing (mNGS) of both the pus and blood showed high reads of multiple pathogens, including anaerobes and the three culture-positive pathogens. Thus, adrenal gland abscess was confirmed, and a combination therapy of catheter drainage and effective antimicrobial treatment was started. Six days later, the patient had clinically improved and mNGS showed dramatically decreased reads of all pathogens. A follow-up lab examination of inflammatory biomarkers was normal, and the adrenal mass was reduced radiographically.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

A rare case of adrenal gland abscess due to anaerobes detected by metagenomic next-generation sequencing

Wu¹,

Miao²,

Wang³

et al. 2020

Ann Transl Med

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“…There is a relative lack of literature on large adrenal abscesses owing to the uncommon nature of these lesions. Adrenal abscesses have been reported in the literature to occur secondary to a placental infection, infected adrenal hemorrhage, immunocompromised states, and in association with pheochromocytomas [3][4][5]7]. Adrenal abscesses can be easily misdiagnosed owing to the uncommon nature of these findings and the diagnostic difficulty in distinguishing between adrenal cystic pathologies such as pseudocysts with or without hemorrhage, and other necrotic adrenal tumors.…”

Section: Discussionmentioning

confidence: 99%

“…These rare lesions are most commonly encountered in the setting of disseminated infection and have been reported in the literature to occur in conjunction with both Nocardia spp. and Streptococcus pneumonia [2][3][4][5]. Though often caused secondarily to fatal bacterial infection, non-infectious causes of adrenal hemorrhage include postoperative state, use of anticoagulants, burns, trauma, tumor metastasis, and cardiovascular collapse [6].…”

Section: Introductionmentioning

confidence: 99%

Role of MRI in the Diagnosis of Large Right Adrenal Abscess

Stankard¹,

Gopireddy²,

Lall³

2020

Cureus

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Adrenal abscesses are extremely rare occurrences with only scattered case reports reported in the literature. Owing to their rarity, they are not usually considered within the typical differential for cystic adrenal masses discovered on computed tomography (CT) or magnetic resonance imaging (MRI). Accurate and timely diagnosis of these lesions is critical to exclude malignancy and ensure appropriate management. In this case report, we describe a post-traumatic case of adrenal abscess associated with Staphylococcus aureus bacteremia and its differentiation from cystic adrenal masses. Specific emphasis is placed on the imaging features seen on CT and MRI and how these features can be utilized to differentiate it from other adrenal pathologies such as adrenal pseudocyst or cystic adrenocortical neoplasm.

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“…Patients with adrenal abscess typically present with longstanding fevers, rigors, anorexia, and asthenia. [ 62 , 63 ] Commonly implicated organisms include Streptococcus pneumonia and Nocardia . The classic presentation of abscesses on CT includes low central attenuation, a well-defined enhancing fibrous capsule, and surrounding inflammatory changes.…”

Section: Perirenal Hemorrhage: a Mimic Of Adrenal Hemorrhagementioning

confidence: 99%

Multimodality imaging of adrenal gland pathologies: A comprehensive pictorial review

Paloka

Gopireddy

Virarkar

et al. 2022

JCIS

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The assessment of acute abdominal and pelvic emergencies typically involves a multimodal approach consisting of plain radiographs, ultrasound, computed tomography (CT), and rarely magnetic resonance imaging (MRI). Although MRI is not traditionally employed in acute care settings, there are several instances in which MRI provides superior functional and prognostic information. In this manuscript, we highlight multimodal findings of adrenal gland emergencies: Hemorrhage, infarction, and infection. The purpose of our study is to highlight significant findings in various modalities, including CT, MRI, ultrasound, and PET/CT. Due to the scarcity of published data and limited clinical use, primary ultrasound findings are limited in our multimodal review. In conclusion, we find that synergistic use of CT, MRI, and functional imaging provides an effective tool for evaluation and management of adrenal pathology.

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Adrenal gland abscess due to Streptococcus pneumoniae

Cited by 7 publications

References 6 publications

A rare case of adrenal gland abscess due to anaerobes detected by metagenomic next-generation sequencing

A rare case of adrenal gland abscess due to anaerobes detected by metagenomic next-generation sequencing

Role of MRI in the Diagnosis of Large Right Adrenal Abscess

Multimodality imaging of adrenal gland pathologies: A comprehensive pictorial review

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