Adrenal gland and paraganglia
Adrenal insufficiency

Reviewer: Nat Pernick, M.D. (see Authors page)

Revised: 1 March 2016, last major update February 2005

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Infections adrenal insufficiency
Table of Contents
Definition / general
Cite this page: Infections. website. Accessed December 14th, 2018.
Definition / general
  • Cytomegalovirus (CMV): common in adrenal glands of AIDS patients, causes adrenocortical necrosis; if severe, may cause adrenal insufficiency
  • Echovirus: case reports of 5 day old twins with dissimilar manifestations of intrauterine infection (Arch Pathol Lab Med 1983;107:361); five newborn infants (Hum Pathol 1983;14:818)
  • Fungi: due to Histoplasma, Cryptococcus and Paracoccidioides; enlarged glands with fibrosis, necrosis and granulomatous inflammation
  • Herpes simplex / varicella zoster: may involve adrenal glands, associated with extensive cortical necrosis; may cause adrenal insufficiency (Hum Pathol 1985;16:1091)
  • HIV: changes due to HIV virus itself, opportunistic infections (Mycobacterium avium-intracellulare, CMV, HSV) or associated neoplasms; may have defect in 17-deoxcorticosteroid production or peripheral resistance to glucocorticoids
  • Mycobacterium avium-intracellulare: sheets of histiocytes with abundant acid-fast organisms detected with acid-fast stains

    • Rare cause of adrenal insufficiency in US and Western Europe, more common elsewhere
    • Due to Mycobacterium tuberculosis
    • No symptoms until glandular destruction almost complete
    • Gross description: adrenal glands are enlarged, yellow-gray-red and replaced by necrotic material
    • Micro description: caseous necrosis of cortex and medulla, Langerhans giant cells and lymphocytes; may have thin rim of intact cortical tissue; 50% have identifiable bacteria with Ziehl-Neelsen or fluorescent stains