Iatrogenic Candida glabrata Fungal Adrenalitis after Endoscopic Ultrasound Cyst Aspiration

Abstract Background: Nosocomial infections play a major role in the morbidity and mortality of surgical patients. Nosocomial fungal infections are particularly difficult to treat and may present in a cryptic manner. We report a case of iatrogenic Candida glabrata necrotizing adrenalitis after endoscopic ultrasound (EUS) retroperitoneal cyst aspiration. Case Presentation: A 43-year-old female with history of hepatitis C presented with an incidental 6.0 cm retroperitoneal cyst found on magnetic resonance imaging (MRI) believed to be arising from the pancreas. The patient underwent EUS-assisted cyst aspiration for tissue diagnosis, however, these results were inconclusive. She underwent laparoscopic resection of the left retroperitoneal cyst along with the attached left adrenal gland. Histopathology revealed no malignant disease or pancreatic cyst; instead, the cyst originated from the adrenal gland and budding yeast was discovered in the cyst. 28S ribosome polymerase chain reaction (PCR) sequencing revealed...