Large adrenal masses with a diameter of ≥4 cm, although infrequently encountered,
should prompt the consideration of 2 main diagnoses— pheochromocytoma and adrenal
cortical carcinoma. In this report, I describe a patient who presented with shock
and multiorgan failure, who was unexpectedly found to have a large adrenal mass on
computed tomography (CT) scan, which was done for localization of infective foci.
He had a stormy initial clinical course, and the possibility of pheochromocytoma crisis
was considered, as “the great masquerader” can present in a myriad of ways. Blood
cultures confirmed melioidosis, investigations excluded pheochromocytoma, and most
significantly, this adrenal mass completely disappeared after 4 months of antibiotic
therapy. This confirmed the diagnosis of disseminated melioidosis with adrenal gland
abscess and is the first reported case of complete resolution of an adrenal abscess
in melioidosis. This case is a reminder to all clinicians why melioidosis had earned
its namesake “the great mimicker” and highlights the importance of a high index of
suspicion for diagnosis.
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Article Info
Publication History
Published online: October 13, 2021
Thomas J. Marrie, MD, Section EditorIdentification
Copyright
© 2021 Elsevier Inc. All rights reserved.
