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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 343:1477-1483 November 16, 2000 Number 20
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Case 35-2000— An 82-Year-Old Woman with Bilateral Adrenal Masses and Low-Grade Fever
Robert Udelsman, and Henry Y. Dong

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Presentation of Case

An 82-year-old woman was admitted to the ambulatory care center because of bilateral adrenal masses and low-grade fever.

The patient had been in good health until five months earlier, when myalgia developed, with a vague headache and a temperature of 37.2°C. A physician prescribed ciprofloxacin because of scheduled cataract surgery. A week later, the patient began to pass three or more loose stools daily, without bleeding. A stool specimen contained Clostridium difficile toxin; another antibiotic was prescribed, and a repeated test for C. difficile toxin was negative. The diarrhea subsided. The cataract extraction was uneventful, and she returned to her . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Robert Udelsman's Diagnosis

Pathological Discussion

Anatomical Diagnosis

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