Abstract
Background: Recognition of Cytomegalovirus related primary adrenal insufficiency in patients with Acquired Immunodeficiency Syndrome (AIDS) requires a high clinical suspicion in patients already on glucocorticoids, especially if the glucocorticoids are to be withdrawn. Case Presentation: We report the case of a 67 year old man with a new diagnosis of Human immunodeficiency virus and multiple AIDS defining illnesses including disseminated Cytomegalovirus infection. The use of six weeks of prednisone therapy for an exacerbation of chronic obstructive pulmonary disease resulted in a delay in the diagnosis of primary adrenal insufficiency from Cytomegalovirus in this patient resulting in marked hypoadrenal symptoms when prednisone therapy was stopped. Conclusion: Our case highlights the importance of investigating for adrenal insufficiency in patients with Cytomegalovirus adrenalitis, regardless of prior or concurrent treatment with glucocorticoids, particularly if glucocorticoids are to be withdrawn.
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