Adrenal gland & paraganglia
Adrenal insufficiency

Topic Completed: 1 February 2005

Minor changes: 19 July 2020

Copyright: 2002-2019,, Inc.

PubMed Search: Infections adrenal insufficiency

Nat Pernick, M.D.
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Table of Contents
Definition / general
Cite this page: Pernick N. Infections. website. Accessed August 6th, 2020.
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, Langhans giant cells and lymphocytes; may have thin rim of intact cortical tissue; 50% have identifiable bacteria with Ziehl-Neelsen or fluorescent stains
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