Infectious causes of Addisons disease: 1 organ--2 organisms!

Background

Infectious aetiologies are the most common causes of primary adrenal failure (Addison's disease) in low/middle-income countries while in the western world autoimmune causes predominate. The infections attributed to cause Addison's include disseminated gonococcal infection, tuberculosis, histoplasmosis, cryptococcosis and cytomegalovirus (CMV) infection. Here, we describe two classical cases of Addison's due to infections of the adrenal gland.

Case presentationCase 1

A 55-year-old woman from North India was admitted with history of multiple episodes of vomiting. She had history of severe loss of appetite and loss of weight. There was also history of increased body pigmentation for the last 6 months. At admission, she was drowsy with tachycardia of 116 beats per minute and her blood pressure was 80/50 mm Hg in supine position associated with a significant postural drop. There was hyperpigmentation of fingers, face, oral mucosa and flexures. The rest of the system examination did not reveal any significant...

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