Fatal factitious Cushing's syndrome and invasive aspergillosis: Case report and review of literature

Devan Kansagara, Jeanette Tetrault, Chalmers Hamill, Caleb Moore, Beatriz Olson

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: To present the first reported fatality from invasive aspergillosis related to factitious Cushing's syndrome. Methods: We summarize the history, clinical findings, and outcome in a patient ultimately found to have factitious Cushing's syndrome. In addition, the dangers of fulminant infections in untreated Cushing's syndrome are analyzed relative to molecular and immunologic aspects, and the pertinent literature is reviewed. Results: A 33-year-old female medical transcriptionist was admitted with rapidly fatal septic shock and diffuse pulmonary infiltrates. Autopsy revealed invasive pulmonary aspergillosis and atrophied adrenal cortices. On subsequent investigation, hidden bottles of prednisone were found throughout the patient's home. Factitious Cushing's syndrome has rarely been described and can be a difficult diagnosis to establish, but it is important to recognize this condition because of its potentially drastic consequences. Our understanding of the mechanism of immunosuppression from glucocorticoids related to the increased risk of invasive fungal infections is evolving. Factitious illness can manifest in numerous ways; therefore, health-care providers in all specialties should be familiar with epidemiologic, diagnostic, and treatment considerations for this illness. Conclusion: Endocrinologists should be aware of the possibility of factitious Cushing's syndrome because it can be an elusive and ultimately fatal condition.

Original languageEnglish (US)
Pages (from-to)651-655
Number of pages5
JournalEndocrine Practice
Volume12
Issue number6
StatePublished - Nov 2006

Fingerprint

Aspergillosis
Cushing Syndrome
Invasive Pulmonary Aspergillosis
losigame
Adrenal Cortex
Septic Shock
Prednisone
Health Personnel
Immunosuppression
Glucocorticoids
Autopsy
History
Lung
Infection

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Kansagara, D., Tetrault, J., Hamill, C., Moore, C., & Olson, B. (2006). Fatal factitious Cushing's syndrome and invasive aspergillosis: Case report and review of literature. Endocrine Practice, 12(6), 651-655.

Fatal factitious Cushing's syndrome and invasive aspergillosis : Case report and review of literature. / Kansagara, Devan; Tetrault, Jeanette; Hamill, Chalmers; Moore, Caleb; Olson, Beatriz.

In: Endocrine Practice, Vol. 12, No. 6, 11.2006, p. 651-655.

Research output: Contribution to journalArticle

Kansagara, D, Tetrault, J, Hamill, C, Moore, C & Olson, B 2006, 'Fatal factitious Cushing's syndrome and invasive aspergillosis: Case report and review of literature', Endocrine Practice, vol. 12, no. 6, pp. 651-655.
Kansagara D, Tetrault J, Hamill C, Moore C, Olson B. Fatal factitious Cushing's syndrome and invasive aspergillosis: Case report and review of literature. Endocrine Practice. 2006 Nov;12(6):651-655.
Kansagara, Devan ; Tetrault, Jeanette ; Hamill, Chalmers ; Moore, Caleb ; Olson, Beatriz. / Fatal factitious Cushing's syndrome and invasive aspergillosis : Case report and review of literature. In: Endocrine Practice. 2006 ; Vol. 12, No. 6. pp. 651-655.
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