Idiopathic hypoparathyroidism with fungal seminal vesiculitis.
A 23-year-old man was suffering from high fever and general fatigue 6 months before admission. The levels of serum Ca and intact-parathyroid hormone (PTH) were low. His brain computed tomography (CT) revealed marked calcifications of the basal ganglia, and pelvis magnetic resonance imaging (MRI) showed inflammation of his seminal vesicle. His candida antigen titer was high and antibiotic therapy was unsuccessful. High fever persisted despite fluconazole treatment, however he recovered after treatment with fluconazole and vitamin D (alfacalcitol). Idiopathic hypoparathyroidism hinders the activation of vitamin D via insufficient PTH secretion, and vitamin D has some immunological effects. His decreased natural killer (NK) cell activity improved after alfacalcitol treatment. We suggest the possible immunological effects of vitamin D in this fungal infection.
Matsuyama
W
W
Third Department of Medicine, Kagoshima University School of Medicine.
Takenaga
S
S
Nakahara
K
K
Kawabata
M
M
Iwakiri
Y
Y
Arimura
K
K
Osame
M
M
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D015725:Fluconazole / Q000627:therapeutic use; D005832:Genital Diseases, Male / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007011:Hypoparathyroidism / Q000209:etiology* / Q000276:immunology; D007249:Inflammation / Q000150:complications / Q000188:drug therapy; D008297:Male; D009181:Mycoses / Q000150:complications* / Q000188:drug therapy; D012669:Seminal Vesicles; D014807:Vitamin D / Q000276:immunology / Q000627:therapeutic use
D000935:Antifungal Agents; D014807:Vitamin D; D015725:Fluconazole