ABSTRACT
Chronic primary adrenal insufficiency and acute adrenal crisis are among the mechanisms responsible for the lethal outcome of patients with paracoccidioidomycosis, especially when they have not been diagnosed in patients submitted to infectious, traumatic, and surgical stress. The original findings indicated that the infection could with a relative high frequency involve the adrenal parenchyma and destroy it. Del Negro suggested that adrenal hypofunction most likely occurred in patients with disseminated paracoccidioidomycosis. Adrenal involvement was documented in 27 of the 56 cases of paracoccidioidomycosis found in the group studied. By damaging the adrenal glands, P. brasiliensis can cause gland dysfunction. In these cases, hormonal replacement with a corticosteroid is usually prescribed throughout the patient's life in view of the recognized irreversibility of the anatomical lesions and of the functional adrenocortical deficiency. In order to correlate adrenal tomography and ultrasound findings with plasma Cortisol and aldosterone levels after the rapid ACTH stimulation test, Tendrich et al.
