Clin Endosc.  2022 Mar;55(2):302-304. 10.5946/ce.2021.090.

Endoscopic Ultrasound-Guided Transgastric Puncture and Drainage of an Adrenal Abscess in an Immunosuppressed Patient

• Regino CA
• Gómez JP
• Mosquera-Klinger G

• KMID: 2527577
• DOI: http://doi.org/10.5946/ce.2021.090

Abstract

Adrenal gland infection is a clinical entity of great importance, but it is a largely unrecognized pathology. Immunosuppressed individuals are at a higher risk of presentation. Herein, we describe a young female patient, recently diagnosed with HIV, who presented with severe sepsis due to methicillin-resistant Staphylococcus aureus, associated with a left adrenal abscess. She was initially treated with antibiotics; however, due to the persistence of the systemic inflammatory response and bacteremia, endoscopic ultrasound-guided drainage was performed. This procedure was successful in resolving the clinical situation. Endoscopic ultrasound-guided adrenal gland drainage can be a safe, efficacious, and minimally invasive option for managing antibiotic-refractory adrenal abscesses in immunosuppressed patients.

Keyword

Abscess; Adrenal glands; Drainage; Endoscopic ultrasound-guided fine-needle aspiration; Endosonography

Figure

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  Fig. 1. (A) Abdominal magnetic resonance imaging, axial section, showing wall enhancement in the left adrenal gland, with evidence of fluid content (red arrow). (B) Linear endoscopic ultrasound view, identifying the markedly enlarged left adrenal gland, with content that appears to be mixed (anechoic/hypoechoic). (C) Aspiration puncture/drainage of the content. (D) A portion of the extracted purulent material sent to the microbiology unit in a dry tube.

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