A Case of Bilateral Nocardia francinia Adrenal Abscesses in an Intravenous Drug-Using Splenectomized Patient With Tricuspid Endocarditis.

Adrenal abscesses due to disseminated nocardiosis are exceedingly rare in clinical practice, and to date only 8 cases have been reported in the literature, most of which were confined to a single adrenal gland. These infections often occur in patients with underlying immune deficiency. We report a rare case of bilateral nocardial adrenal abscesses in an intravenous drug-using splenectomized patient that presumably originated from direct inoculation using intravenous opana, as his admission chest radiograph was normal.