title: Secondary adrenal insufficiency manifested as an acute febrile illness.
abstract: High fever occurred in a 30-year-old woman five weeks after transsphenoidal hypophysectomy for a pituitary adenoma. Extensive investigation failed to reveal any evidence of infection, and the clinical findings suggested the fever to be a manifestation of steroid withdrawal. Either suboptimal dosage of corticosteroid replacement therapy or omission of such therapy in adrenal insufficiency must be considered in the differential diagnosis of enigmatic postoperative fever.
authors.affiliation: Department of Medicine, East Tennessee State University College of Medicine, Johnson City 37614-0002.
authors.forename: J L
authors.initials: JL
authors.lastname: Soto-Hernandez
authors.forename: A
authors.initials: A
authors.lastname: Verghese
authors.forename: B D
authors.initials: BD
authors.lastname: Hall
authors.forename: C P
authors.initials: CP
authors.lastname: Cole
authors.forename: H B
authors.initials: HB
authors.lastname: Cupp
mesh_terms: D000208:Acute Disease; D000309:Adrenal Insufficiency / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D000328:Adult; D003348:Cortisone / Q000031:analogs & derivatives / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007016:Hypophysectomy; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology*
chemical_list: D003348:Cortisone