Adrenal Abscesses: A Systematic Review of the Literature

Једноставна страница ставке
dc.citation.spage4601
dc.citation.volume12
dc.contributor.authorGligorijevic, Nikola
dc.contributor.authorKaljevic, Marija
dc.contributor.authorRadovanovic, Natasa
dc.contributor.authorJovanovic, Filip
dc.contributor.authorJoksimovic, Bojan
dc.contributor.authorSingh, Sandra
dc.contributor.authorDumic, Igor
dc.date.accessioned2024-12-03T12:24:09Z
dc.date.available2024-12-03T12:24:09Z
dc.date.issued2023
dc.description.abstractObjective: To summarize the existing knowledge about adrenal gland abscesses, including etiology, clinical presentation, common laboratory and imaging findings, management and overall morbidity and mortality. Design: Systematic literature review. Methods: We performed a search in the PubMed database using search terms: ‘abscess and adrenal glands’, ‘adrenalitis’, ‘infection and adrenal gland’, ‘adrenal abscess’, ‘adrenal infection’ and ‘infectious adrenalitis’. Articles from 2017 to 2022 were included. We found total of 116 articles, and after applying exclusion criteria, data from 73 articles was included in the final statistical analysis. Results: Of 84 patients included in this review, 68 were male (81%), with a mean age of 55 years (range: 29 to 85 years). Weight loss was the most frequent symptom reported in 58.3% patients, followed by fever in 49%. Mean duration of symptoms was 4.5 months. The most common laboratory findings were low cortisol (51.9%), elevated ACTH (43.2%), hyponatremia (88.2%) and anemia (83.3%). Adrenal cultures were positive in 86.4% cases, with Histoplasma capsulatum (37.3%) being the leading causative agent. Blood cultures were positive in 30% of patients. The majority of the adrenal infections occurred through secondary dissemination from other infectious foci and abscesses were more commonly bilateral (70%). A total of 46.4% of patients developed long-term adrenal insufficiency requiring treatment. Abscess drainage was performed in 7 patients (8.3%) and adrenalectomy was performed in 18 (21.4%) patients. The survival rate was 92.9%. Multivariate analysis showed that the only independent risk factor for mortality was thrombocytopenia (p = 0.048). Conclusion: Our review shows that adrenal abscesses are usually caused by fungal pathogens, and among these, Histoplasma capsulatum is the most common. The adrenal glands are usually involved in a bilateral fashion and become infected through dissemination from other primary sources of infection. Long-term adrenal insufficiency develops in 46% of patients, which is more common than what is observed in non-infectious etiology of adrenal gland disorders. Mortality is about 7%, and the presence of thrombocytopenia is associated with worse prognosis. Further prospective studies are needed to better characterize optimal testing and treatment duration in patients with this relatively rare but challenging disorder.
dc.identifier.doi10.3390/jcm12144601
dc.identifier.urihttps://vaseljena.ues.rs.ba/handle/123456789/1373
dc.language.isoen
dc.publisherMDPI
dc.sourceJournal of Clinical Medicine
dc.subjectadrenal abscess; adrenal infection; adrenal insufficiency; histoplasmosis
dc.titleAdrenal Abscesses: A Systematic Review of the Literature
dc.typeArticle
Датотеке
Оригинални завежљај
Сада се приказује 1 - 1 од 1
Сличица
Име:
Adrenal Abscesses A Systematic Review of the Literature.pdf
Величина:
1.61 MB
Формат:
Adobe Portable Document Format
Опис:
Преузимање
Свежањ лиценце
Сада се приказује 1 - 1 од 1
Сличица
Име:
license.txt
Величина:
1.71 KB
Формат:
Item-specific license agreed to upon submission
Опис:
Преузимање
Колекције
Медицински факултет [Научни радови] / Faculty of Medicine [Scientific papers]