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.