Multiple concomitant life-threatening opportunistic infections due to uncontrolled hypercortisolism

Abstract

Opportunistic infections associated with severe cortisol excess carry a high mortality rate and are most prevalent with ectopic ACTH syndrome. There are limited reports of these cases described in the literature. In this case report, we describe multiple severe life-threatening opportunistic infections due to endogenous hypercortisolism. Our patient, against numerous expectations, survived multiple opportunistic infections including disseminated invasive aspergillosis, Cytomegalovirus endophthalmitis and Pneumocystis Jirovecii pneumonia, reinforcing the need for multidisciplinary care for patients presenting with complicated hypercortisolism.

Endocrine Fever

“…9 Cushing's syndrome predisposes to opportunistic infections like cryptococcosis, aspergillosis, nocardiosis, and pneumocystis, necessitating appropriate prophylaxis. 10 Endocrine glands are also prone to endemic fungal infections such as histoplasmosis, coccidioidomycoses and paracoccidiodomycoses. 11 Functional fever due to hyperresponsiveness of enodcrine system Sometimes, the term 'fever' is poetically linked to other endocrine phenomena, such as 'fever of the heart' or 'heartbreak fever' in Indian literature.…”