The adrenal gland is a common site of metastasis due to its rich blood supply. Adrenalectomy is typical treatment in the management of oligometastatic disease. We present an unexpected finding of cytomegalovirus (CMV)-related adrenalitis mimicking adrenal metastasis. A 54-year-old female was reviewed with a history of BRCA2-mutated, hormone receptor-positive invasive ductal cancer of the right breast diagnosed 12 years prior. Surveillance fluorodeoxyglucose positron emission tomography (FDG-PET) demonstrated a new focus of FDG avidity in the left adrenal gland, for which she underwent adrenalectomy. Histopathology revealed CMV-related adrenalitis in an otherwise immunocompetent patient without history of human immunodeficiency virus (HIV) or other immunocompromise. We describe the first case of CMV adrenalitis in a patient without acquired immunodeficiency syndrome. This case was initially presumed to be adrenal metastasis in the context of disseminated metastatic breast cancer and a PET-avid left adrenal lesion.

: Objective: Alcohol and drug use is an established factor contributing to traumatic injury globally. However, its prevalence and impact within regional and remote populations is poorly characterised. This study examines associations between alcohol and drug use and clinical outcomes among major trauma patients in North Queensland. Methods: A retrospective audit was conducted of all major trauma patients in the Townsville University Hospital Trauma Registry Information System between October 2022 and October 2023. Demographic, injury and outcome data were investigated. Patients were categorised by alcohol and drug use and compared using descriptive and non-parametric analysis. Results: Of 319 eligible patients, 110 (34.4%) patients were identified within the alcohol and drug cohort. Alcohol was most frequently detected (82.7%) followed by cannabis (20.0%) and amphetamines (12.7%) and 20 (18.2%) reported polysubstance use. Alcohol and/or drug-positive patients were significantly younger (40.7 vs 49.0 years, p<0.05), more likely to be injured by assault (OR 6.9 (95% CI: 3.1-15.3), p<0.001), admitted to ICU (OR 1.5 (95% CI: 0.9-2.5), p=0.069) and required longer hospital stays (11.9 ± 13.9 days vs 10.4 ± 11.4 days, p=0.656). Discharge and mortality outcomes did not differ between groups. Conclusion: This study highlights the impact of alcohol and drug use in regional major trauma patients, who often require greater healthcare utilisation. Standardised testing, targeted prevention and tailored clinical pathways may improve outcomes and reduce the burden of alcohol and drug-related trauma. Due to the inconsistent screening practices, the true prevalence remains uncertain, warranting further research to determine the impact and guide interventions.

Objective: Alcohol and drug use is an established factor contributing to traumatic injury globally, yet regional and remote prevalence and impact are poorly characterised. This study examines associations between alcohol and drug use and clinical outcomes among major trauma patients in North Queensland. Methods: A retrospective audit of major trauma patients in Townsville University Hospital Trauma Registry between October 2022–2023. Patients were classified by alcohol and drug use based on toxicology results and electronic medical record. Demographic, injury and outcome variables were compared using descriptive and non‐parametric analysis. Results: Of 319 eligible patients, 110 (34.4%) patients were identified within the alcohol and drug cohort. Alcohol was most frequently detected (82.7%), followed by cannabis (20.0%) and amphetamines (12.7%), with 18.2% demonstrating polysubstance use. Alcohol and/or drug‐positive patients were significantly younger (40.7 vs. 49.0 years, p = 0.002) and more likely to sustain assault‐related injuries (OR 6.9 (95% CI: 3.1–15.3), p < 0.001). No statistical significance was found between groups for ICU admission rate, ICU LOS or hospital LOS. Discharge and mortality outcomes did not differ between groups. Conclusion: This study highlights the impact of alcohol and drug use in regional major trauma patients. Standardised testing, targeted prevention and tailored clinical pathways may improve outcomes and reduce the burden of alcohol and drug‐related trauma. Inconsistent screening practices mean the true prevalence remains uncertain, warranting further research to determine the impact and guide interventions.