Jens Christian Richter1, B Chappuis. 1. Klinik für Innere Medizin, Regionalspital Emmental, Burgdorf, Schweiz. j.c.richter_md@hotmail.com
Abstract
HISTORY AND CLINICAL FINDINGS: A 69-year-old man was admitted with cough, fever and dyspnea. For years, an adrenal insufficiency has been substituted with low-dose hydrocortisone. The hypotensive and tachycardic patient exhibited remarkable stony hard ears. INVESTIGATIONS: Elevated inflammatory markers and the clinical picture point to a pulmonary focus of infection. Radiographs of the ears show trabecular structures as a sign of true ossification. DIAGNOSIS, TREATMENT AND COURSE: Addisonian crisis due to pulmonary infection was treated successfully with steroids, antibiotics and intravenous fluids. The auricular ossification was interpreted as a secondary phenomenon of undersubstituted adrenal insufficiency. CONCLUSION: Adrenal insufficiency should be considered when auricular ossification is encountered. The pathogenesis of this phenomenon is complex and not well understood. Georg Thieme Verlag KG Stuttgart * New York.
HISTORY AND CLINICAL FINDINGS: A 69-year-old man was admitted with cough, fever and dyspnea. For years, an adrenal insufficiency has been substituted with low-dose hydrocortisone. The hypotensive and tachycardic patient exhibited remarkable stony hard ears. INVESTIGATIONS: Elevated inflammatory markers and the clinical picture point to a pulmonary focus of infection. Radiographs of the ears show trabecular structures as a sign of true ossification. DIAGNOSIS, TREATMENT AND COURSE: Addisonian crisis due to pulmonary infection was treated successfully with steroids, antibiotics and intravenous fluids. The auricular ossification was interpreted as a secondary phenomenon of undersubstituted adrenal insufficiency. CONCLUSION:Adrenal insufficiency should be considered when auricular ossification is encountered. The pathogenesis of this phenomenon is complex and not well understood. Georg Thieme Verlag KG Stuttgart * New York.