European Journal of Internal Medicine
Volume 20, Issue 3 , Pages 319-322, May 2009

Fungal disease of the Western hemisphere: A patient with coccidioidomycosis

  • Geert A Buijze

      Affiliations

    • Department of General Internal Medicine, Haga Ziekenhuis, Leyweg 275, 2545 CH, Den Haag, The Netherlands
    • Corresponding Author InformationCorresponding author. Willem de Zwijgerlaan 65, 2582 EH, Den Haag, The Netherlands. Tel.: +312 05 662 874.
  • ,
  • Petra Kok

      Affiliations

    • Department of General Internal Medicine, Haga Ziekenhuis, Leyweg 275, 2545 CH, Den Haag, The Netherlands
    • Mayo Clinic, Endocrine Research Unit, Rochester, MN 55905, USA
  • ,
  • Stella A Botha-Scheepers

      Affiliations

    • Department of General Internal Medicine, Haga Ziekenhuis, Leyweg 275, 2545 CH, Den Haag, The Netherlands
  • ,
  • Sierd J Smith

      Affiliations

    • Department of General Internal Medicine, Haga Ziekenhuis, Leyweg 275, 2545 CH, Den Haag, The Netherlands
  • ,
  • Harm P Sleeboom

      Affiliations

    • Department of General Internal Medicine, Haga Ziekenhuis, Leyweg 275, 2545 CH, Den Haag, The Netherlands

Received 11 December 2007; received in revised form 15 July 2008; accepted 19 August 2008. published online 20 October 2008.

Abstract 

We report the case of a 58 year old male patient with nonproductive coughing, fever, vomiting and loss of appetite, beginning at the moment that he returned back home from a 2 week holiday in California. His symptoms were accompanied by increased inflammatory markers in his blood (leucocytosis, high CRP) and pulmonary sequelae, becoming more prominent shortly after admission. Eventually, the final diagnosis of coccidioidomycosis was made by histopathology and confirmed by serology. Coccidioidomycosis is a rare infectious disease. However, the incidence in the endemic areas of this fungal infection is increasing and the population travelling towards its specific endemic regions in the United States and Southern America is considerably growing. Clinicians facing patients with pulmonary infection with the appropriate travel history and persistent pulmonary or systemic infection (with or without eosinophilia) should be alert to the possibility of coccidioidomycosis. Therefore, we present an up to date overview of the epidemiology, microbiology, clinical features, diagnosis and treatment of patients with coccidioidomycosis.

Keywords: Pulmonary eosinophilia, Mycoses, Fungal spores, Microbiology, Antimycotic agents

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PII: S0953-6205(08)00254-9

doi:10.1016/j.ejim.2008.08.014

European Journal of Internal Medicine
Volume 20, Issue 3 , Pages 319-322, May 2009