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Adrenal gland and paraganglia

Adrenal insufficiency

Infections

Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 6 February 2013, last major update February 2005
Copyright: (c) 2002-2013, PathologyOutlines.com, Inc.

General
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● 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

Tuberculosis:
● 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

End of Adrenal gland and paraganglia > Adrenal insufficiency > Infections

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