title: [A case of acute respiratory distress syndrome caused by cryptococcus and cytomegalovirus co-infection after Cushing's syndrome treatment].
abstract: We report a case of severe Cushing's syndrome developing into life-threatening acute respiratory distress syndrome with cryptococcus and cytomegalovirus co-infection soon after hypercortisolism treatment using metyrapone, an 11-beta-hydroxylase inhibitor. We speculate that a restored immune response would have elicited clinical symptoms of opportunistic and previously subclinical infection. The immunocompromised state and the delicate glucocorticoid balance in subjects with severe Cushing's syndrome necessitate a specific diagnostic and therapeutic approach.
authors.affiliation: Department of Oncology, Hematology, and Infectious Diseases, Fukuoka University School of Medicine.
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Goto
authors.forename: Tohru
authors.initials: T
authors.lastname: Takata
authors.forename: Eiichi
authors.initials: E
authors.lastname: Sato
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tamura
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yanase
mesh_terms: D000369:Aged, 80 and over; D060085:Coinfection / Q000175:diagnosis / Q000188:drug therapy*; D003453:Cryptococcosis / Q000150:complications / Q000188:drug therapy*; D003480:Cushing Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008797:Metyrapone / Q000009:adverse effects / Q000627:therapeutic use*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D008797:Metyrapone